scholarly journals Bloodstream infections caused by ST2 Acinetobacter baumannii : Risk factors, antibiotic regimens, and virulence over 6 years period in China

2020 ◽  
Author(s):  
Kaihang Yu ◽  
Weiliang Zeng ◽  
Ye Xu ◽  
Wenli Liao ◽  
Wenya Xu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acinetobacter Baumannii ◽  
Bloodstream Infection ◽  
Bloodstream Infections ◽  
Tertiary Hospital ◽  
Multidrug Resistant ◽  
High Serum ◽  
Hospitalized Patients ◽  
Effective Treatment Option ◽  
Difficult Challenge

Abstract Background: Bloodstream infection (BSI) caused by multidrug-resistant Acinetobacter baumannii (MDR-AB) has been increasingly observed among hospitalized patients. The following study analyzed the epidemiology and microbiological characteristics of MDR-AB, as well as the clinical features, antimicrobial treatments, and outcomes in patients over a six years period in ChinaMethods: This retrospective study was conducted in a large tertiary hospital in China between January 2013 and December 2018. The clinical and microbiological data of all consecutive hospitalized patients with MDR-AB induced bloodstream infection were included and analyzed. Results: A total of 108 BSI episodes were analyzed. All MDR isolates belonged to ST2, a sequence type that has spread all over the world. Overall, ST2 strains showed strong biofilm formation ability, high serum resistance, and high pathogenicity. As for the clinical characteristics of the patient, 30-day mortality was 69.4% (75/108). The three main risk factors included mechanical ventilation, intensive care unit (ICU) stay, and thrombocytopenia; three protective factors included a change of antimicrobial regimen within 48 h after positive blood culture, use of the antibacterial agent combination, and more inpatient days. The most effective antibacterial regimen was the combination of cefoperazone/sulbactam and tigecycline.Conclusions: BSI caused by ST2 A.baumannii represents a difficult challenge for physicians, considering the high mortality associated with this infection. The combination of cefoperazone/sulbactam and tigecycline may be an effective treatment option.

scholarly journals Bloodstream infections caused by ST2 Acinetobacter baumannii: Risk factors, antibiotic regimens, and virulence over 6 years period in China

2020 ◽  
Author(s):  
Kaihang Yu ◽  
Weiliang Zeng ◽  
Ye Xu ◽  
Wenli Liao ◽  
Wenya Xu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acinetobacter Baumannii ◽  
Bloodstream Infection ◽  
Bloodstream Infections ◽  
Tertiary Hospital ◽  
Multidrug Resistant ◽  
High Serum ◽  
Hospitalized Patients ◽  
Effective Treatment Option ◽  
Difficult Challenge

Abstract Background: Bloodstream infection (BSI) caused by multidrug-resistant Acinetobacter baumannii (MDR-AB) has been increasingly observed among hospitalized patients. The following study analyzed the epidemiology and microbiological characteristics of MDR-AB, as well as the clinical features, antimicrobial treatments, and outcomes in patients over a six years period in ChinaMethods: This retrospective study was conducted in a large tertiary hospital in China between January 2013 and December 2018. The clinical and microbiological data of all consecutive hospitalized patients with MDR-AB induced bloodstream infection were included and analyzed.Results: A total of 108 BSI episodes were analyzed. All MDR isolates belonged to ST2. Overall, ST2 strains showed strong biofilm formation ability, high serum resistance, and high pathogenicity. As for the clinical characteristics of the patient, 30-day mortality was 69.4% (75/108). The three main risk factors included mechanical ventilation, intensive care unit (ICU) stay, and thrombocytopenia; three protective factors included a change of antimicrobial regimen within 48 h after bacteria isolation from blood, use of the antibacterial agent combination, and more inpatient days. The most effective antibacterial regimen was the combination of cefoperazone/sulbactam and tigecycline.Conclusions: BSI caused by ST2 A.baumannii represents a difficult challenge for physicians, considering the high mortality associated with this infection. The combination of cefoperazone/sulbactam and tigecycline may be an effective treatment option.

scholarly journals Bloodstream infections caused by ST2 Acinetobacter baumannii: risk factors, antibiotic regimens, and virulence over 6 years period in China

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Kaihang Yu ◽  
Weiliang Zeng ◽  
Ye Xu ◽  
Wenli Liao ◽  
Wenya Xu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acinetobacter Baumannii ◽  
Bloodstream Infection ◽  
Bloodstream Infections ◽  
Tertiary Hospital ◽  
Multidrug Resistant ◽  
High Serum ◽  
Hospitalized Patients ◽  
Effective Treatment Option ◽  
Difficult Challenge

Abstract Background Bloodstream infection (BSI) caused by multidrug-resistant Acinetobacter baumannii (MDR-AB) has been increasingly observed among hospitalized patients. The following study analyzed the epidemiology and microbiological characteristics of MDR-AB, as well as the clinical features, antimicrobial treatments, and outcomes in patients over a six years period in China. Methods This retrospective study was conducted in a large tertiary hospital in China between January 2013 and December 2018. The clinical and microbiological data of all consecutive hospitalized patients with MDR-AB induced bloodstream infection were included and analyzed. Results A total of 108 BSI episodes were analyzed. All MDR isolates belonged to ST2, a sequence type that has spread all over the world. Overall, ST2 strains showed strong biofilm formation ability, high serum resistance, and high pathogenicity. As for the clinical characteristics of the patient, 30-day mortality was 69.4% (75/108). The three main risk factors included mechanical ventilation, intensive care unit (ICU) stay, and thrombocytopenia; three protective factors included a change of antimicrobial regimen within 48 h after positive blood culture, use of the antibacterial agent combination, and more inpatient days. The most effective antibacterial regimen was the combination of cefoperazone/sulbactam and tigecycline. Conclusions BSI caused by ST2 A.baumannii represents a difficult challenge for physicians, considering the high mortality associated with this infection. The combination of cefoperazone/sulbactam and tigecycline may be an effective treatment option.

scholarly journals Bloodstream infections caused by ST2 Acinetobacter baumannii over 6 years in China: risk factors, antibiotic regimens and virulence

2020 ◽  
Author(s):  
Kaihang Yu ◽  
Weiliang Zeng ◽  
Ye Xu ◽  
Wenli Liao ◽  
Wenya Xu ◽  
...  
Keyword(s):  
Acinetobacter Baumannii ◽  
Biofilm Formation ◽  
Bloodstream Infections ◽  
Tertiary Hospital ◽  
Multidrug Resistant ◽  
Sequence Type ◽  
Microbiological Characteristics ◽  
Difficult Challenge ◽  
Microbiological Data

Abstract Background Acinetobacter baumannii (Ab) is an important pathogen of medical-related infections, A.baumannii sequence type 2 (ST2) has spread all over the world. To the best of our knowledge, this is the first study to analyze the clinical and microbiological characteristics of patients with bloodstream infection (BSI) due to ST2 A.baumannii. Methods A retrospective study was conducted in a large tertiary hospital in China. From January 2013 to December 2018, the clinical and microbiological data of all consecutive hospitalized patients with bacteremia due to multidrug-resistant A.baumannii (MDR-AB) were included and analyzed comprehensively. Results A total of 108 episodes of BSI due to MDR-AB cases were enrolled during the study period. Overall, 30-day mortality was 69.4% (75/108). The use of mechanical ventilation, intensive care unit (ICU) stay and thrombocytopenia may cause higher mortality (P = 0.048, P < 0.001, and P < 0.001, respectively). Change antimicrobial within 48 h after isolating from blood, use of antibacterial combination and more inpatient days were significantly associated with survival (P < 0.001, P = 0.037, and P = 0.007, respectively). All MDR isolates belong to ST2, and have strong biofilm formation ability and high pathogenicity. Conclusions BSI caused by ST2 A.baumannii represents a difficult challenge for physicians, considering the high mortality associated with this infection. The combination of cefoperazone/sulbactam and tigecycline may be a meaningful treatment option.

scholarly journals Risk Factors and Clinical Outcomes of Mixed Acinetobacter Baumannii Bloodstream Infection

2021 ◽  
Author(s):  
Zhenhua Qian ◽  
Shufang Zhang ◽  
Na Li ◽  
Weixing Ma ◽  
Kai Zhang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Soft Tissue ◽  
Acinetobacter Baumannii ◽  
Bloodstream Infection ◽  
Clinical Outcomes ◽  
Burn Injury ◽  
Rare Event ◽  
Tertiary Hospital ◽  
Significant Difference ◽  
Poor Outcomes

Abstract Background: Although the clinical features of Acinetobacter baumannii bloodstream infection are well described, the specific clinical characteristics of mixed Acinetobacter baumannii bloodstream infection are rarely reported. The objective of this study was to examine the risk factors and clinical outcomes of mixed Acinetobacter baumannii bloodstream infection. Methods: A retrospectively observational study was performed from January 2013 to December 2018 in a tertiary hospital. All patients with Acinetobacter baumannii bloodstream infection were enrolled,the data were collected from electronic medical records. Results: A total of 594 episodes were enrolled, 21% (126/594) of which were mixed Acinetobacter baumannii bloodstream infection.The most common co-pathogens were Klebsiella pneumoniae (20.81%), followed by Pseudomonas aeruginosa (16.78%) and Enterococcus faecium (12.08%). Compared with monomicrobial Acinetobacter baumannii bloodstream infection, the main source of mixed Acinetobacter baumannii bloodstream infection was from skin and soft tissue(28.6% vs.10.5%, P<0.001). A multivariate analysis revealed burn injury was independently associated with mixed Acinetobacter baumannii bloodstream infection(adjusted odds ratio,3.569; 95% confidence interval, 1.954-6.516). Patients with mixed Acinetobacter baumannii bloodstream infection were more likely to have longer hospitalization length of stay [40(21,68) vs. 27(16,45), P<0.001]and hospitalization days after BSI [22(8,50) vs. 13(4,28), P<0.001]. However, no significant difference in mortality was observed between the two groups. Conclusions: Mixed Acinetobacter baumannii bloodstream infection is not a rare event, which accounts for one fifth of all Acinetobacter baumannii bloodstream infection. The main source is from skin and soft tissue, and burn injury is an independent risk factor. Although the mortality is not different, patients with mixed Acinetobacter baumannii bloodstream infection might have poor outcomes, which merits more attention by physicians in the future.

scholarly journals Multidrug resistant and extensively drug resistant Acinetobacter baumannii hospital infection associated with high mortality: A retrospective study in the Pediatric Intensive Care Unit

2020 ◽  
Author(s):  
Jingyi Shi ◽  
Ting Sun ◽  
Yun Cui ◽  
Chunxia Wang ◽  
Fei Wang ◽  
...  
Keyword(s):  
Serum Level ◽  
Acinetobacter Baumannii ◽  
High Mortality ◽  
Pediatric Intensive Care ◽  
Bloodstream Infections ◽  
Multidrug Resistant ◽  
High Serum ◽  
Drug Resistant ◽  
Extensively Drug Resistant ◽  
Overall Mortality

Abstract Background Multidrug resistant (MDR) and extensively drug resistant (XDR) Acinetobacter baumannii presents challenges for clinical treatment and causes high mortality in children. We aimed to assess the risk factors for MDR/XDR Acinetobacter baumannii infection and for overall mortality in this patient population. Methods This retrospective study included 102 pediatric patients who developed MDR/XDR Acinetobacter baumannii infection in the pediatric intensive care unit (PICU) of Shanghai Children’s Hospital in China from December 2014 to May 2018. Clinical presentations and outcome of the patients were analyzed. The primary outcome was overall mortality. Secondary outcomes included the 28-day mortality and the length of hospital stay. Results Of the 102 patients (63 males and 39 females; mean age: 51.79 months), the overall mortality rate was 29.41%. 18(17.64%) had bloodstream infections;4(3.92%) for which cerebrospinal fluid (CSF) cultures were positive; 14(13.73%) of them got positive cultures in aseptic fluid; 10 (9.8%) had central catheter-associated bloodstream infections; lower respiratory isolates (56/102) accounted for 54.9% of all patients. Non-survival patients appeared to have a lower NK cell activity 5.87%(2.43%, 8.93%) vs. 8.45%(4.51%, 14.61%), P =0.011), higher CD4 + T cell ratio (35.32% (29%, 47.81%) vs. 31.97% (20.52%, 38.22%), P = 0.045), and higher serum level of interlukin-6 (IL-6, 235.51(0.1, 4172.77) pg/ml vs. 0.1(0.1, 110.92) pg/ml, P = 0.028), interlukin-8 (IL-8, 22.73(3.14, 540.12) vs. 0.1(0.1, 25.85)pg/ml, P = 0.03) , and interlukin-10(10.82(0.1, 83.29)pg/ml vs. 6.05(0.1,21.81)pg/ml) were observed. Multivariate logistic analysis indicated that high serum level of BUN (RR, 1.216, 95%CI, 1.27-2.616; P = 0.001) and high serum level of Cr (RR, 1.823, 95%CI, 0.902-0.980；P=0.004,) were associated with high risk of overall mortality in MDR/XDR Acinetobacter baumannii infected patients. Conclusion MDR/XDR- Acinetobacter baumannii is an important opportunistic pathogen that causes nosocomial infection in PICU with a rather high mortality. The incidence increased in recent years, ineffective management, immune dysfunction, acute kidney injury contributed to the risk of death.

scholarly journals Clinical Outcomes and Risk Factors for Tunneled Hemodialysis Catheter-Related Bloodstream Infections

2020 ◽  
Vol 7 (6) ◽  
Author(s):  
Kylie Martin ◽  
Yves S Poy Lorenzo ◽  
Po Yee Mia Leung ◽  
Sheri Chung ◽  
Emmet O’flaherty ◽  
...  
Keyword(s):  
Risk Factors ◽  
Bloodstream Infection ◽  
Jugular Vein ◽  
Insertion Site ◽  
Bloodstream Infections ◽  
Left Internal Jugular Vein ◽  
Hemodialysis Catheter ◽  
Increased Risk ◽  
Catheter Related Bloodstream Infection ◽  
Reduced Risk

Abstract Diabetes and left internal jugular vein insertion site were significantly associated with increased risk of a catheter-related bloodstream infection from a tunneled hemodialysis catheter. Ex-smoker status was significantly associated with reduced risk.

scholarly journals In VitroandIn VivoAntimicrobial Activities of Gallium Nitrate against Multidrug-Resistant Acinetobacter baumannii

2012 ◽  
Vol 56 (11) ◽  
pp. 5961-5970 ◽  
Author(s):  
Luísa C. S. Antunes ◽  
Francesco Imperi ◽  
Fabrizia Minandri ◽  
Paolo Visca
Keyword(s):  
Human Serum ◽  
Acinetobacter Baumannii ◽  
Galleria Mellonella ◽  
Therapeutic Potential ◽  
Survival Rates ◽  
Bloodstream Infections ◽  
Multidrug Resistant ◽  
Gallium Nitrate ◽  
Content Type ◽  
Bacterial Physiology

ABSTRACTMultidrug-resistantAcinetobacter baumanniiposes a tremendous challenge to traditional antibiotic therapy. Due to the crucial role of iron in bacterial physiology and pathogenicity, we investigated iron metabolism as a possible target for anti-A. baumanniichemotherapy using gallium as an iron mimetic. Due to chemical similarity, gallium competes with iron for binding to several redox enzymes, thereby interfering with a number of essential biological reactions. We found that Ga(NO3)3, the active component of an FDA-approved drug (Ganite), inhibits the growth of a collection of 58A. baumanniistrains in both chemically defined medium and human serum, at concentrations ranging from 2 to 80 μM and from 4 to 64 μM, respectively. Ga(NO3)3delayed the entry ofA. baumanniiinto the exponential phase and drastically reduced bacterial growth rates. Ga(NO3)3activity was strongly dependent on iron availability in the culture medium, though the mechanism of growth inhibition was independent of dysregulation of gene expression controlled by the ferric uptake regulator Fur. Ga(NO3)3also protectedGalleria mellonellalarvae from lethalA. baumanniiinfection, with survival rates of ≥75%. At therapeutic concentrations for humans (28 μM plasma levels), Ga(NO3)3inhibited the growth in human serum of 76% of the multidrug-resistantA. baumanniiisolates tested by ≥90%, raising expectations on the therapeutic potential of gallium for the treatment ofA. baumanniibloodstream infections. Ga(NO3)3also showed strong synergism with colistin, suggesting that a colistin-gallium combination holds promise as a last-resort therapy for infections caused by pan-resistantA. baumannii.

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