Risk factors for fatality of Acinetobacter baumannii bloodstream infection / 中华临床感染病杂志

ABSTRACT

Objective To investigate the antibiotic resistance of Acinetobacter baumannii,and to identify the risk factors for fatality of Acinetobacter baumannii bloodstream infection.Methods A retrospective review was conducted on 80 patients with Acinetobacter baumannii bloodstream infections admitted in Tianjin General Hospital during January 2011 to May 2014.Clinical data including demographic information,the ward of stay,underlying diseases,treatment,invasive procedures,antibiotic resistance,acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score at admission were collected.Multivariate Logistic regression analysis was performed to identify the risk factors for fatality.Results There were ≥90％ strains resistant to ceftazidime,ceftriaxone and cefoxitin,and 66.3％ strains were resistant to imipenem.While most strains were sensitive to cefoperazone/shubatan and tigecycline,and the resistance rates were 7.5％ and 2.5％,respectively.ICU admission (OR =6.67,95％ CI2.01-22.07,P ＜0.01),multi-drug resistance (OR =3.55,95％ CI1.30-9.69,P ＜ 0.05),APACHE Ⅱ score ≥ 19 (OR =39.00,95％ CI9.87-154.09,P ＜ 0.01),artery catheterization (OR =3.24,95％ CI1.16-9.04,P ＜ 0.05),central venous catheterization (OR =3.33,95％ CI1.22-9.12,P ＜ 0.05),tracheal catheterization (OR=3.60,95％CI1.31-9.88,P＜0.05),tracheostomy (OR=3.21,95％CI1.19-8.66,P＜0.05),and other invasive procedures (OR =3.00,95％ CI1.11-8.08,P ＜ 0.05) were the risk factors for fatality.Conclusion Invasive procedures and multi-drug resistance are associated with increased fatality of patients with Acinetobacter baumannii bloodstream infection.