The risk factors associated with bloodstream infections caused by multi-drug resistant Acinetobacter baumannii / 中国感染与化疗杂志

ABSTRACT

Objective To investigate the risk factors of bloodstream infections caused by multiple drug resistant Acinetobacter baumannii (MDRAB) and those associated with 30-day clinical outcomes of MDRAB patients. Methods A case-control study was designed to retrospectively analyze 49 cases of MDRAB-related bloodstream infections treated in our hospital during the period from January 2013 to December 2014. Additional 29 cases of non-MDRAB bloodstream infections were included as control group. Univariate and multivariate logistic analysis were used to identify the risk factors of MDRAB bloodstream infections. The prognostic factors were analyzed similarly for all the 78 cases of bloodstream infections by comparing the relevant factors between survival group (38 cases) and non-survival group (40 cases) based on the survival status 30 days after collecting blood samples. Results Univariate analysis revealed that the risk factors for MDRAB bloodstream infection included use of carbapenems, quinolones, or at least 2 antibiotics, mechanical ventilation, nasogastric tube, indwelled central venous catheter, and ICU stay prior to infection. Subsequent multivariate logistic analysis showed that ICU stay (OR=7.118) and prior use of at least 2 antibiotics (OR=8.073) were independent risk factors for MDRAB bloodstream infection. Univariate analysis revealed that ICU stay, mechanical ventilation,and MDRAB in blood sample were the prognostic factors of 30-day survival. Multiple logistic regression analysis showed that MDRAB infection (OR=5.837) and mechanical ventilation (OR=4.926) were the independent risk factors predicting of 30-day patient death. Conclusions ICU stay and prior use of at least 2 antibiotics were independent risk factors for MDRAB bloodstream infection. MDRAB infection and mechanical ventilation were the independent risk factors predicting 30-day patient death in MDRAB bloodstream infections.