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Predictors of mortality in patients infected with carbapenem-resistant Acinetobacter baumannii: A systematic review

Xingran Du1, Xinfeng Xu2, Jing Yao3

  • 1Department of Infectious Disease, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, China.

American Journal of Infection Control
|April 21, 2019
PubMed

Insights

Carbapenem-resistant Acinetobacter baumannii (CRAB) infections pose a significant threat. Inappropriate empirical antibiotic treatment and severe baseline conditions are key predictors of mortality in CRAB patients.

Area of Science:

  • Infectious Diseases
  • Critical Care Medicine
  • Antimicrobial Resistance

Background:

  • Carbapenem-resistant Acinetobacter baumannii (CRAB) is a critical global health threat.
  • Conflicting results exist regarding mortality predictors in CRAB infections.

Purpose of the Study:

  • To systematically identify and synthesize predictors of mortality in patients with CRAB infections.
  • To inform clinical practice and improve patient outcomes.

Main Methods:

  • Systematic literature search of PubMed, Embase, and Cochrane Library databases (up to June 2018).
  • Inclusion of 19 observational studies.
  • Independent data extraction and assessment by two authors.

Main Results:

  • Inappropriate empirical antimicrobial treatment (OR, 5.04) and septic shock (OR, 5.65) were significant mortality predictors.
  • Chronic comorbidities including liver disease (OR, 2.36), renal disease (OR, 2.02), and hypertension (OR, 1.74) increased mortality risk.
  • Higher severity scores (APACHE II, Pitt bacteremia) were observed in non-survivors.

Conclusions:

  • Baseline patient condition severity and inappropriate empirical antibiotic therapy are major risk factors for CRAB mortality.
  • Findings can guide preventive strategies to reduce mortality in CRAB infections.
Abstract

Keywords:
Bloodstream infectionCarbapenem resistanceNosocomial pneumoniaRisk factors

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