Risk factors of multidrug resistance in nosocomial bacteremia due to Acinetobacter baumannii: A case-control study

Mu Jen Shih, Nan-Yao Lee, Hsin Chun Lee, Chia-Ming Chang, Chi Jung Wu, Po-Lin Chen, Nai-Ying Ko, Wen-Chien Ko

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Abstract

Background and Purpose: Acinetobacter baumannii is an important nosocomial pathogen. Bacteremia caused by multidrug-resistant A. baumannii (MDRAB) leads to higher mortality and medical cost compared with non-MDRAB bacteremia. We aimed to identify risk factors of multidrug resistance in A. baumannii bacteremia. Methods: A matched case-control study was conducted to compare the differences in risk factors of patients with MDRAB and non-MDRAB bacteremia. Results: Sixty three patients with MDRAB bacteremia and 63 matched patients with non-MDRAB bacteremia were identified from hospital and laboratory records of the period 1996 to 2002. Multivariate logistic regression analysis identified four independent risk factors associated with multidrug resistance in A. baumannii bacteremic patients: previous colonization with A baumannii (odds ratio [OR], 7.99; 95% confidence interval [CI], 2.1-30.6; p=0.002), antecedent antimicrobial therapy (OR, 6.10; 95% CI, 1.2-29.9; p=0.026) the number of recently prescribed antibiotics (OR 1.35; 95% CI, 1.0-1.8; p=0.026), and recent invasive procedures (OR, 4.17; 95% CI, 1.6-11.1;p=0.004). Conclusions: Overall, patients with MDRAB bacteremia had earlier A baumannii colonization, greater previous exposure to antimicrobial agents and recent invasive procedures. The results of this study demonstrate a rationale for the development of effective interventions to minimize the impact of MDRAB.

Original languageEnglish
Pages (from-to)118-123
Number of pages6
JournalJournal of Microbiology, Immunology and Infection
Volume41
Issue number2
Publication statusPublished - 2008 Apr 1

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Acinetobacter baumannii
Multiple Drug Resistance
Bacteremia
Case-Control Studies
Odds Ratio
Confidence Intervals
Hospital Laboratories
Hospital Records
Anti-Infective Agents
Logistic Models
Regression Analysis

All Science Journal Classification (ASJC) codes

  • Immunology and Allergy
  • Immunology and Microbiology(all)
  • Microbiology (medical)
  • Infectious Diseases

Cite this

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title = "Risk factors of multidrug resistance in nosocomial bacteremia due to Acinetobacter baumannii: A case-control study",
abstract = "Background and Purpose: Acinetobacter baumannii is an important nosocomial pathogen. Bacteremia caused by multidrug-resistant A. baumannii (MDRAB) leads to higher mortality and medical cost compared with non-MDRAB bacteremia. We aimed to identify risk factors of multidrug resistance in A. baumannii bacteremia. Methods: A matched case-control study was conducted to compare the differences in risk factors of patients with MDRAB and non-MDRAB bacteremia. Results: Sixty three patients with MDRAB bacteremia and 63 matched patients with non-MDRAB bacteremia were identified from hospital and laboratory records of the period 1996 to 2002. Multivariate logistic regression analysis identified four independent risk factors associated with multidrug resistance in A. baumannii bacteremic patients: previous colonization with A baumannii (odds ratio [OR], 7.99; 95{\%} confidence interval [CI], 2.1-30.6; p=0.002), antecedent antimicrobial therapy (OR, 6.10; 95{\%} CI, 1.2-29.9; p=0.026) the number of recently prescribed antibiotics (OR 1.35; 95{\%} CI, 1.0-1.8; p=0.026), and recent invasive procedures (OR, 4.17; 95{\%} CI, 1.6-11.1;p=0.004). Conclusions: Overall, patients with MDRAB bacteremia had earlier A baumannii colonization, greater previous exposure to antimicrobial agents and recent invasive procedures. The results of this study demonstrate a rationale for the development of effective interventions to minimize the impact of MDRAB.",
author = "Shih, {Mu Jen} and Nan-Yao Lee and Lee, {Hsin Chun} and Chia-Ming Chang and Wu, {Chi Jung} and Po-Lin Chen and Nai-Ying Ko and Wen-Chien Ko",
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T1 - Risk factors of multidrug resistance in nosocomial bacteremia due to Acinetobacter baumannii

T2 - A case-control study

AU - Shih, Mu Jen

AU - Lee, Nan-Yao

AU - Lee, Hsin Chun

AU - Chang, Chia-Ming

AU - Wu, Chi Jung

AU - Chen, Po-Lin

AU - Ko, Nai-Ying

AU - Ko, Wen-Chien

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N2 - Background and Purpose: Acinetobacter baumannii is an important nosocomial pathogen. Bacteremia caused by multidrug-resistant A. baumannii (MDRAB) leads to higher mortality and medical cost compared with non-MDRAB bacteremia. We aimed to identify risk factors of multidrug resistance in A. baumannii bacteremia. Methods: A matched case-control study was conducted to compare the differences in risk factors of patients with MDRAB and non-MDRAB bacteremia. Results: Sixty three patients with MDRAB bacteremia and 63 matched patients with non-MDRAB bacteremia were identified from hospital and laboratory records of the period 1996 to 2002. Multivariate logistic regression analysis identified four independent risk factors associated with multidrug resistance in A. baumannii bacteremic patients: previous colonization with A baumannii (odds ratio [OR], 7.99; 95% confidence interval [CI], 2.1-30.6; p=0.002), antecedent antimicrobial therapy (OR, 6.10; 95% CI, 1.2-29.9; p=0.026) the number of recently prescribed antibiotics (OR 1.35; 95% CI, 1.0-1.8; p=0.026), and recent invasive procedures (OR, 4.17; 95% CI, 1.6-11.1;p=0.004). Conclusions: Overall, patients with MDRAB bacteremia had earlier A baumannii colonization, greater previous exposure to antimicrobial agents and recent invasive procedures. The results of this study demonstrate a rationale for the development of effective interventions to minimize the impact of MDRAB.

AB - Background and Purpose: Acinetobacter baumannii is an important nosocomial pathogen. Bacteremia caused by multidrug-resistant A. baumannii (MDRAB) leads to higher mortality and medical cost compared with non-MDRAB bacteremia. We aimed to identify risk factors of multidrug resistance in A. baumannii bacteremia. Methods: A matched case-control study was conducted to compare the differences in risk factors of patients with MDRAB and non-MDRAB bacteremia. Results: Sixty three patients with MDRAB bacteremia and 63 matched patients with non-MDRAB bacteremia were identified from hospital and laboratory records of the period 1996 to 2002. Multivariate logistic regression analysis identified four independent risk factors associated with multidrug resistance in A. baumannii bacteremic patients: previous colonization with A baumannii (odds ratio [OR], 7.99; 95% confidence interval [CI], 2.1-30.6; p=0.002), antecedent antimicrobial therapy (OR, 6.10; 95% CI, 1.2-29.9; p=0.026) the number of recently prescribed antibiotics (OR 1.35; 95% CI, 1.0-1.8; p=0.026), and recent invasive procedures (OR, 4.17; 95% CI, 1.6-11.1;p=0.004). Conclusions: Overall, patients with MDRAB bacteremia had earlier A baumannii colonization, greater previous exposure to antimicrobial agents and recent invasive procedures. The results of this study demonstrate a rationale for the development of effective interventions to minimize the impact of MDRAB.

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