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Risk factors for 30-day mortality in patients with carbapenem-resistant Acinetobacter baumannii during an outbreak in

C G Prates1, A F Martins, S V Superti

  • 1Medical Sciences Postgraduate Program, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.

Epidemiology and Infection
|June 2, 2010
PubMed

Insights

This study identified key risk factors for 30-day mortality in patients with carbapenem-resistant Acinetobacter baumannii (CRAB) infections. Septic shock and high APACHE II scores significantly increased mortality risk during the ICU outbreak.

Area of Science:

  • Infectious Diseases
  • Critical Care Medicine
  • Microbiology

Background:

  • Carbapenem-resistant Acinetobacter baumannii (CRAB) poses a significant threat in intensive care units (ICUs).
  • Outbreaks of CRAB necessitate understanding mortality risk factors for effective management.

Purpose of the Study:

  • To identify independent risk factors associated with 30-day mortality in patients with CRAB infection or colonization.
  • To evaluate the impact of clinical characteristics and treatment on mortality during a CRAB outbreak.

Main Methods:

  • Retrospective analysis of 66 patients with CRAB infection or colonization during an ICU outbreak.
  • Multivariate Cox regression analysis to determine predictors of 30-day mortality.
  • Assessment of clinical and demographic data, including APACHE II scores and therapeutic interventions.

Main Results:

  • The overall 30-day mortality rate was 47.0%.
  • Septic shock (aHR 5.01) and higher APACHE II scores (aHR 1.11) were significantly associated with increased 30-day mortality.
  • Appropriate therapy showed a trend towards reduced mortality (aHR 0.48) but was not statistically significant, often initiated late with suboptimal dosing.

Conclusions:

  • Severe baseline condition and presentation severity are major mortality risk factors in CRAB outbreaks.
  • Prompt and optimal therapeutic interventions are crucial for improving outcomes in CRAB infections.
  • The blaOXA-23 gene was prevalent among tested CRAB isolates, indicating a common resistance mechanism.

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