Comparison of pneumonia and nonpneumonia-related Acinetobacter baumannii complex bacteremia: A single-center
1Intensive Care Unit, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 79 Qingchun Rd, Hangzhou, 310003, P. R. China.
Background:
Acinetobacter baumannii complex (ABC) is a group of increasingly prevalent opportunistic pathogens that cause a variety of life-threatening nosocomial infections, especially in the intensive care unit (ICU). This study assessed the differences between pneumonia- and non-pneumonia-related ABC bacteremia and possible independent risk factors for 30-day mortality.
Methods:
The clinical data of ICU patients diagnosed with ABC bacteremia at a tertiary care hospital from January 2009 to December 2020 were collected, and sorted into groups of ABC bacteremia with and without pneumonia.
Results:
Significant changes in the incidence of ABC bacteremia and antibiotic resistance were observed over the 12-year study. Compared with nonpneumonia-related ABC bacteremia, pneumonia-related ABC bacteremia was associated with a higher rate of hypertension, less prior tigecycline use, more carbapenem-resistant (CR) strains, and a higher 30-day mortality rate. In multivariate analysis, immunosuppression, higher APACHE II score, and SOFA score were independent risk factors for 30-day mortality. Moreover, the risk of death was 1.919 times higher in the pneumonia-related group.
Conclusions:
Although pneumonia-related ABC bacteremia had worse outcomes, it was not an independent risk factor for death statistically. Immunosuppression and disease severity levels increased the risks of death in ICU patients with ABC bacteremia.
Insights
Acinetobacter baumannii complex (ABC) bacteremia with pneumonia shows worse outcomes but is not an independent mortality risk. Immunosuppression and disease severity are key risk factors for death in ICU patients.
Area of Science:
- Infectious Diseases
- Critical Care Medicine
- Clinical Microbiology
Background:
- Acinetobacter baumannii complex (ABC) causes severe hospital-acquired infections, particularly in intensive care units (ICUs).
- Understanding differences between pneumonia-related and non-pneumonia-related ABC bacteremia is crucial for patient outcomes.
- This study investigates risk factors for 30-day mortality in ABC bacteremia.
Purpose of the Study:
- To compare clinical characteristics and outcomes of pneumonia-related versus non-pneumonia-related ABC bacteremia.
- To identify independent risk factors associated with 30-day mortality in ICU patients with ABC bacteremia.
- To analyze trends in ABC bacteremia incidence and antibiotic resistance over a 12-year period.
Main Methods:
- Retrospective analysis of clinical data from ICU patients with ABC bacteremia (2009-2020).
- Patients were categorized into pneumonia-related and non-pneumonia-related groups.
- Multivariate analysis was employed to determine independent risk factors for 30-day mortality.
Main Results:
- Significant changes in ABC bacteremia incidence and antibiotic resistance were noted over 12 years.
- Pneumonia-related ABC bacteremia was linked to higher hypertension rates, more carbapenem-resistant strains, and increased 30-day mortality.
- Independent risk factors for 30-day mortality included immunosuppression, higher APACHE II, and SOFA scores.
Conclusions:
- Pneumonia-related ABC bacteremia is associated with poorer outcomes but not an independent predictor of mortality.
- Immunosuppression and disease severity (APACHE II, SOFA scores) are significant independent risk factors for death.
- Effective management strategies should focus on patient factors like immunosuppression and disease severity.
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