Objectives:
To analyze treatment, clinical outcomes, and predictors of mortality in hospitalized patients with
Acinetobacter baumannii
infection.
Methods:
Retrospective cohort study of inpatients with
A. baumannii
cultures and treatment from 2010-2019. Patients who died during admission were compared to those who survived to identify predictors of inpatient mortality, using multivariable unconditional logistic regression models.
Results:
We identified 4,599 inpatients with
A. baumannii
infection; 13.6% died during admission. Fluoroquinolones (26.8%), piperacillin/tazobactam (24%) and carbapenems (15.6%) were used for treatment. Tigecycline (3%) and polymyxins (3.7%) were not used often. Predictors of inpatient mortality included current acute respiratory failure (adjusted odds ratio [aOR] 3.94), shock (aOR 3.05), and acute renal failure (aOR 2.01); blood (aOR 1.94) and respiratory (aOR 1.64) infectious source; multidrug-resistant
A. baumannii
(MDRAB) infection (aOR 1.66); liver disease (aOR 2.15); and inadequate initial treatment (aOR 1.30). Inpatient mortality was higher in those with MDRAB vs. non-MDRAB (aOR 1.61) and in those with CRAB vs. non-CRAB infection (aOR 1.68). Length of stay >10 days was higher among those with MDRAB vs. non-MDRAB (aOR 1.25) and in those with CRAB vs. non-CRAB infection (aOR 1.31).
Conclusions:
In our national cohort of inpatients with
A. baumannii
infection, clinical outcomes were worse among those with MDRAB and/or CRAB infection. Predictors of inpatient mortality included several current conditions associated with severity, infectious source, underlying illness, and inappropriate treatment. Our study may assist healthcare providers in the early identification of admitted patients with
A. baumannii
infection who are at higher risk of death.
Evaluation of Clinical outcomes after Tigecycline and Colistin Treatment against Multidrug-resistant Acinetobacter baumannii
