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Impact of imipenem resistance on mortality in patients with Acinetobacter bacteraemia

Ki Tae Kwon1, Won Sup Oh, Jae-Hoon Song

  • 1Division of Infectious Diseases, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Seoul 135-710, Korea.

The Journal of Antimicrobial Chemotherapy
|January 11, 2007
PubMed
Abstract

Insights

Imipenem resistance in Acinetobacter bacteraemia significantly increases mortality. This is primarily due to discordant antimicrobial therapy, highlighting the need for appropriate treatment strategies.

Area of Science:

  • Infectious Diseases
  • Clinical Microbiology
  • Hospital Epidemiology

Background:

  • Acinetobacter bacteraemia poses a significant threat in healthcare settings.
  • Imipenem resistance is a growing concern, complicating treatment options.

Purpose of the Study:

  • To determine the effect of imipenem resistance on mortality in Acinetobacter bacteraemia patients.
  • To identify factors contributing to mortality in this patient group.

Main Methods:

  • A retrospective, matched cohort study involving 80 patients with Acinetobacter bacteraemia.
  • Risk adjustment for age and Pitt bacteraemia score was performed.
  • Comparison between imipenem non-susceptible (INAB) and imipenem-susceptible (ISAB) groups.

Main Results:

  • The 30-day mortality rate was substantially higher in the INAB group (57.5%) versus the ISAB group (27.5%).
  • Discordant antimicrobial therapy was more frequent in the INAB group (65.0%) and strongly associated with increased mortality (67.6%).
  • Imipenem resistance independently predicted mortality when discordant therapy was accounted for.

Conclusions:

  • Imipenem resistance significantly elevates mortality risk in Acinetobacter bacteraemia.
  • The increased mortality is largely driven by inappropriate (discordant) antimicrobial therapy.
  • Optimizing antimicrobial selection is crucial for improving outcomes in imipenem-resistant infections.

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