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Attributable mortality of imipenem-resistant nosocomial Acinetobacter baumannii bloodstream infection

Silom Jamulitrat1, Pranee Arunpan, Parichart Phainuphong

  • 1Department of Community Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand. jsilom@medicine.psu.ac.th

Journal of the Medical Association of Thailand = Chotmaihet Thangphaet
|March 24, 2009
PubMed
Abstract

Insights

Mortality in Acinetobacter baumannii bloodstream infections was higher in imipenem-resistant (IRAB) cases. However, after adjusting for other factors, imipenem resistance itself did not significantly increase patient mortality.

Area of Science:

  • Infectious Diseases
  • Clinical Microbiology
  • Antimicrobial Resistance

Background:

  • High mortality rates are associated with Acinetobacter baumannii infections.
  • Uncertainty exists regarding the specific contribution of imipenem resistance to mortality in these infections.

Purpose of the Study:

  • To evaluate the impact of imipenem resistance on mortality in patients with Acinetobacter baumannii bloodstream infections.

Main Methods:

  • A cohort study design was employed.
  • Compared survival rates between patients with imipenem-resistant A. baumannii (IRAB) and imipenem-susceptible A. baumannii (ISAB) bacteremia.
  • Multivariate analysis using Cox's proportional hazard model controlled for confounding factors.

Main Results:

  • Patients with IRAB bacteremia had a higher in-hospital mortality rate (52.2%) compared to ISAB bacteremia (19.9%).
  • Multivariate analysis revealed no statistically significant difference in mortality rates between the IRAB and ISAB groups when controlling for disease severity, treatment, and infection source.

Conclusions:

  • The higher observed mortality in IRAB infections may be linked to factors other than imipenem resistance.
  • Severe underlying illness, inappropriate antibiotic therapy, and the primary source of infection are potential contributors to increased mortality.

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