Objective To analyze related factors affecting the
prognosis of
patients with
Acinetobacter baumannii (A.baumannii)
bloodstream infection(BSI),guide clinical prevention and
treatment.
Methods A
case-control study was conducted to retrospectively analyze
patients with A.baumannii BSI in
Peking University Third
Hospital from January 2012 to December 2016.According to
prognosis,
patients were dividedinto poor
prognosis group and good
prognosis group. Univariate
analysis and
logistic regression analysis were used to analyze the
risk factors of poor
prognosis in
patients with A.baumannii BSI.Results There were 58 confirmed cases of A.baumannii BSI,including 31
patients with poor
prognosis and 27 with good
prognosis. Univariate
analysis revealed that
risk factors for poor
prognosis of A.baumannii BSI were antimicrobial use and at least two kinds of
antimicrobial agent use three months before admission,at least two kinds of antimicrobial use,and
carbapenems use before
infection after admission,increase of
white blood cell(WBC)count after
infection(P<0.05). After 3-day anti-infective treat-ment,examination results of WBC count and
X-ray chest film in good
prognosis group were all better than poor
prognosis group(P<0.05). Logistic multivariate
regression analysis showed that independent
risk factors for poor
prognosis of A.bau m annii BSI were antimicrobial use three months before admission,at least three kinds of antimicrobial use and
carbapenem use before
infection after admission,increase of WBC count and WBC count>12×109/L after infec-tion,as well as increase of WBC count and WBC count>15×109/L after 3-day anti-infective
treatment(P<0.05). Conclusion The
probability of poor
prognosis is high in
patients with A.baumannii
infection. For
patients receiv-ing≥2 kinds of
antimicrobial agents three months before admission,
patients receiving≥3 kinds of
antimicrobial agents as well as
patients receiving
carbapenems before
infection after admission,the likelihood of A.baumannii BSI should be paid
attention.For
patients with WBC count>12×109/L after
infection and WBC count>15×109/L after 3-day
treatment,poor
prognosis should be alerted,
treatment plan
needs to be adjusted in
time to reduce the
mortality.