Mortality Rates Associated With Multidrug-Resistant Acinetobacter baumannii Infection in Surgical Intensive Care Units

A retrospective, propensity-matched cohort study was conducted to determine the mortality rate in patients with healthcare-associated infection (HAI) due to multidrug-resistant (MDR) Acinetobacter baumannii. The 28-day mortality rate for patients with MDR A. baumannii HAI was not significantly different than that for patients with non-MDR A. baumannii HAI. The median length of hospital stay before diagnosis of HAI was 4.5 days longer for patients with MDR A. baumannii infection than for patients with non-MDR A. baumannii infection (P <.001).

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A Qualitative Study About Multidrug-Resistant Acinetobacter baumannii (MDRAB) in Healthcare-Associated Infection (HCAI) and Its Resistance Towards Carbapenem in Indonesia

KnE Life Sciences ◽

10.18502/kls.v4i12.4181 ◽

2019 ◽

Vol 4 (12) ◽

pp. 255

Author(s):

W Primaningtyas ◽

A Putri ◽

L Saptawati ◽

J Sudarsono ◽

C Cheng ◽

...

Keyword(s):

Qualitative Study ◽

Acinetobacter Baumannii ◽

Multidrug Resistant ◽

Healthcare Associated Infection ◽

Healthcare Associated

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Clinical and Economic Impact of Multidrug Resistance in Nosocomial Acinetobacter baumannii Bacteremia

Infection Control and Hospital Epidemiology ◽

10.1086/517954 ◽

2007 ◽

Vol 28 (6) ◽

pp. 713-719 ◽

Cited By ~ 135

Author(s):

Nan-Yao Lee ◽

Hsin-Chun Lee ◽

Nai-Ying Ko ◽

Chia-Ming Chang ◽

Hsin-I Shih ◽

...

Keyword(s):

Mortality Rate ◽

Hospital Stay ◽

Acinetobacter Baumannii ◽

Tertiary Care ◽

Length Of Hospital Stay ◽

Multidrug Resistant ◽

Economic Outcomes ◽

University Teaching ◽

Attributable Mortality ◽

The Impact

Objective.To investigate the impact of antimicrobial resistance on clinical and economic outcomes among hospitalized patients with multidrug-resistant (MDR) Acinetobacter baumannii bacteremia.Design.A retrospective, matched-cohort study.Setting.A tertiary care university teaching hospitalMethods.A matched case-control (1:1) study was conducted to compare the differences in clinical and economic outcomes of patients with MDR A. baumannii bacteremia and patients with non-MDR A. baumannii bacteremia. Case patients were matched to control patients on the basis of sex, age, severity of underlying and acute illness, and length of hospital stay before onset of bacteremia.Results.Forty-six (95.8%) of 48 cases with MDR A. baumannii bacteremia were eligible for the study and matched with appropriate controls. The sepsis-related mortality rate was 34.8% among cases and 13.0% among controls, for an attributable mortality rate of 21.8% (adjusted odds ratio, 4.1 [95% confidence interval, 1.1-15.7]; P = .036). After the onset of bacteremia, cases and controls had a significantly different length of hospital stay (54.2 vs 34.1 days; P = .006), hospitalization cost (US$9,349 vs US$4,865; P = .001 ), and antibiotic therapy cost (US$2,257 vs US$1,610; P = .014). Thus, bacteremia due to MDR A. baumannii resulted in 13.4 days of additional hospitalization and US$3,758 of additional costs, compared with bacteremia due to non-MDR A. baumannii.Conclusions.Patients with MDR A. baumannii bacteremia had a higher mortality rate and incurred greater medical costs than patients with non-MDR A. baumannii bacteremia.

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Comparison of Virulence Attributable to Different Levels of Antimicrobial Resistant Acinetobacter baumannii Bacteremia

Journal of the Medical Association of Thailand ◽

10.35755/jmedassocthai.2021.05.10894 ◽

2021 ◽

Vol 104 (5) ◽

pp. 715-722

Keyword(s):

Mortality Rate ◽

Acinetobacter Baumannii ◽

Mortality Rates ◽

Multidrug Resistant ◽

Drug Resistant ◽

Proportional Hazard ◽

Cox Proportional Hazard ◽

Inappropriate Treatment ◽

Crude Mortality ◽

Hospital Acquired

Objective: To determine the mortality rate and severity of sepsis in patients who have acquired drug resistant Acinetobacter baumannii (AB) bacteremia (ABB). Materials and Methods: Microbiology data and information of adult patients hospitalized at Songklanagarind Hospital with positive blood culture for AB between January 2008 and April 2017 were retrieved and reviewed. Antimicrobial resistance was classified into four categories comprising of non-multidrug-resistant (nMDR), multidrug-resistant (MDR), extensively-drug-resistant (XDR), and possible-pandrug-resistant (pPDR). The primary outcome of bacteremia was the in-hospital mortality rate, with the additional outcome, being severity of sepsis represented by the Sepsis Severity Score (SSS). The differences in mortality rates were assessed by Cox proportional hazard model. Results of analysis were reported in terms of hazard ratio (HR) and corresponding 95% confidence interval (CI). Comparison of SSS was evaluated by generalized linear model (GLM) and reported in term of odds ratio (OR). Results: The present study identified 480 patients with hospital-acquired ABB. The proportions among resistance categories were 11%, 39%, 47%, and 3% with crude mortality rates of 20%, 34%, 69%, and 75% for nMDR, MDR, XDR, and pPDR, respectively. GLM analysis showed ORs for higher SSS score in the appropriate treated MDR, and XDR were 1.09 (1.01 to 1.19), and 1.12 (1.03 to 1.22), respectively. The inappropriate treatment ORs for nMDR, MDR, XDR, and pPDR were 1.17 (0.99 to 1.39), 1.30 (1.17 to 1.45), 1.17 (1.08 to 1.28), and 1.01 (0.87 to 1.17), respectively. Conclusion: The virulence of AB was not reduced when its level of antibiotic resistance was upgraded. Keywords: Acinetobacter baumannii; Drug resistance; Bacteremia; Mortality; Virulence

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Prevalence of multidrug-resistant Acinetobacter baumannii in a critical care setting: A tertiary teaching hospital experience

SAGE Open Medicine ◽

10.1177/20503121211001144 ◽

2021 ◽

Vol 9 ◽

pp. 205031212110011

Author(s):

Thabit Alotaibi ◽

Abdulrhman Abuhaimed ◽

Mohammed Alshahrani ◽

Ahmed Albdelhady ◽

Yousef Almubarak ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Mortality Rate ◽

Acinetobacter Baumannii ◽

Care Setting ◽

Multidrug Resistant ◽

University Hospital ◽

Published Data ◽

Tertiary Teaching ◽

The Mean

Background: The management of Acinetobacter baumannii infection is considered a challenge especially in an intensive care setting. The resistance rate makes it difficult to manage and is believed to lead to higher mortality. We aim to investigate the prevalence of Acinetobacter baumannii and explore how different antibiotic regimens could impact patient outcomes as there are no available published data to reflect our population in our region. Methods: We conducted a retrospective review of all infected adult patients admitted to the intensive care unit at King Fahad University Hospital with a confirmed laboratory diagnosis of Acinetobacter baumannii from 1 January 2013 until 31 December 2017. Positive cultures were obtained from the microbiology department and those meeting the inclusive criteria were selected. Variables were analyzed using descriptive analysis and cross-tabulation. Results were further reviewed and audited by blinded co-authors. Results: A comprehensive review of data identified 198 patients with Acinetobacter baumannii. The prevalence of Acinetobacter baumannii is 3.37%, and the overall mortality rate is 40.81%. Our sample consisted mainly of male patients, that is, 68.7%, with a mean age of 49 years, and the mean age of female patients was 56 years. The mean age of survivors was less than that of non-survivors, that is, 44.95 years of age. We observed that prior antibiotic use was higher in non-survivors compared to survivors. From the review of treatment provided for patients infected with Acinetobacter baumannii, 65 were treated with colistin alone, 18 were treated with carbapenems, and 22 were treated with a combination of both carbapenems and colistin. The mean length of stay of Acinetobacter baumannii–infected patients was 20.25 days. We found that the survival rates among patients who received carbapenems were higher compared to those who received colistin. Conclusion: We believe that multidrug-resistant Acinetobacter baumannii is prevalent and associated with a higher mortality rate and represents a challenging case for every intensive care unit physician. Further prospective studies are needed.

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Healthcare associated pneumonia: An old concept at a hospital with high prevalence of antimicrobial resistance

MedPharmRes ◽

10.32895/ump.mpr.5.2.4 ◽

2021 ◽

Vol 5 (2) ◽

pp. 17-21

Author(s):

Lam Nguyen-Ho ◽

Duong Hoang-Thai ◽

Vu Le-Thuong ◽

Ngoc Tran-Van

Keyword(s):

Risk Factor ◽

Antimicrobial Resistance ◽

Multidrug Resistant ◽

Community Acquired Pneumonia ◽

Resistant Organism ◽

Healthcare Associated Infection ◽

Female Ratio ◽

High Prevalence ◽

Need To Evaluate ◽

Healthcare Associated

Background: One of several reasons that the concept of healthcare-associated pneumonia (HCAP) was dismissed was the same presence of multidrug resistant organism (MDRO) between community-acquired pneumonia and HCAP at countries with the low prevalence of antimicrobial resistance (AMR). However, this finding could be unsuitable for countries with the high rates of AMR. Methods: A prospective observational study was conducted at the respiratory department of Cho Ray hospital from September 2015 to April 2016. All adult patients suitable for community acquired pneumonia (CAP) with risk factor for healthcare-associated infection were included. Results: We found out 130 subjects. The median age was 71 years (interquartile range 57-81). The male/female ratio was 1.55:1. Prior hospitalization was the most common risk factor for healthcare-associated infection. There were 35 cases (26.9%) with culture-positive (sputum and/or bronchial lavage). Isolated bacteria included Pseudomonas aeruginosa (9 cases), Klebsiella pneumoniae (9 cases), Escherichia coli (4 cases), Acinetobacter baumannii (6 cases), and Staphylococcus aureus (7 cases) with the characteristic of AMR similar to the bacterial spectrum associated with hospital-acquired pneumonia. Conclusion: MDROs were detected frequently in CAP patients with risk factor for healthcare-associated infection at the hospital with the high prevalence of AMR. This requires the urgent need to evaluate risk factors for MDRO infection in community-onset pneumonia when the concept of HCAP is no longer used.

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Comparative Analysis of Dalbavancin versus Other Antimicrobial Options for Gram-Positive cocci Infections: Effectiveness, Hospital Stay and Mortality

Antibiotics ◽

10.3390/antibiotics10111296 ◽

2021 ◽

Vol 10 (11) ◽

pp. 1296

Author(s):

Mar de Pablo-Miró ◽

Sergi Pujol-Ruiz ◽

Simona Iftimie ◽

María del Mar Arenas-Miras ◽

Inmaculada López-Montesinos ◽

...

Keyword(s):

Hospital Stay ◽

Length Of Hospital Stay ◽

Multidrug Resistant ◽

Ambulatory Setting ◽

Bivariate Analysis ◽

Gram Positive ◽

Healthcare Associated ◽

Remarkable Reduction ◽

Gram Positive Cocci ◽

Control Study

Dalbavancin is a new antibiotic that is effective against Gram-positive microorganisms, including methicillin-resistant Staphylococci, and offers the possibility of administering intravenous therapy once weekly in an ambulatory setting. We conducted a multicenter observational case-control study, comparing all patients who received dalbavancin (cases) with hospitalized patients who were treated instead with daptomycin, linezolid or vancomycin (controls), based on clinical diagnosis, main microorganism involved, and age. The primary outcome was the length of hospital stay after starting the study antimicrobial. Secondary outcomes were 7-day and 30-day efficacy, 30-day mortality, 90-day recurrence, 90-day and 6-month hospitalization, presence of adverse events and healthcare-associated infections; 161 patients (44 cases and 117 controls) were included. Bivariate analysis showed that dalbavancin reduced the total length of hospital stay (p < 0.001), with fewer 90-day recurrences (p = 0.005), 6-month hospitalizations related to the same infection (p = 0.004) and non-related hospitalizations (p = 0.035). Multivariate analyses showed that length of hospital stay was significantly shorter in patients treated with dalbavancin (−12.05 days 95% CI [−17.00, −7.11], p < 0.001), and 30-day efficacy was higher in the dalbavancin group (OR 2.62 95% CI [1.07, 6.37], p = 0.034). Although sample size of the study may be a limitation, we can conclude that Dalbavancin is a useful antimicrobial drug against Gram-positive infections, including multidrug-resistant pathogens, and allows for a remarkable reduction in length of hospital stay with greater 30-day efficacy.

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Mortality Associated with Acinetobacter baumannii Complex Bacteremia among Patients with War-Related Trauma

Infection Control and Hospital Epidemiology ◽

10.1086/649220 ◽

2010 ◽

Vol 31 (1) ◽

pp. 92-94 ◽

Cited By ~ 16

Author(s):

Grace Kang ◽

Joshua D. Hartzell ◽

Robin Howard ◽

Robert N. Wood-Morris ◽

Mark D. Johnson ◽

...

Keyword(s):

Mortality Rate ◽

Acinetobacter Baumannii ◽

Young Patients ◽

Multidrug Resistant ◽

Low Risk ◽

Risk Of Death ◽

High Prevalence ◽

Acinetobacter Baumannii Complex ◽

Resistant Strains

We investigated the mortality associated with Adnetobacter baumannii complex bacteremia among a cohort of patients hospitalized for war-related trauma. Despite a high prevalence of multidrug-resistant strains, the 30-day mortality rate was 2%. For relatively young patients with war-related trauma, A. baumannii complex bacteremia appears to be associated with a low risk of death.

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