TY - JOUR
T1 - Clinical manifestations, antimicrobial therapy, and prognostic factors of monomicrobial Acinetobacter baumannii complex bacteremia
AU - Lee, Nan Yao
AU - Chang, Tsung Chain
AU - Wu, Chi Jung
AU - Chang, Chia Ming
AU - Lee, Hsin Chun
AU - Chen, Po Lin
AU - Lee, Ching Chi
AU - Ko, Nai Ying
AU - Ko, Wen Chien
N1 - Funding Information:
This work was financially supported by grants from National Cheng Kung University Hospital, Tainan ( NCKUH-9703037 ), and Multidisciplinary Center of Excellence for Clinical Trial and Research ( DOH99-TD-B-111-102 ), Department of Health, Executive Yuan, Taiwan .
Copyright:
Copyright 2011 Elsevier B.V., All rights reserved.
PY - 2010/9
Y1 - 2010/9
N2 - Objectives: Bacteremia due to Acinetobacter baumannii complex (ABC), which composed of four genomic species (gen. sp.), is a serious and potentially fatal condition. The epidemiology and outcome of such infections due to individual gen. sp. remain undefined. Methods: A retrospective study of patients with monomicrobial ABC bacteremia over six years was conducted at a medical center to determine the association of gen. sp. with clinical outcome. Results: Included were 291 patients with monomicrobial ABC bacteremia. Of them, 222 (76.3%) patients had bacteremia caused by gen. sp. 2, i.e. A. baumannii. The presence of multidrug-resistant phenotype was the only independent predictor of Acinetobacter gen. sp. 2 bacteremia (adjusted odd ratio, 7.5; 95% confidence interval, 3.8-14.7; P < 0.001). Patients with Acinetobacter gen. sp. 2 bacteremia had a higher sepsis-related (P = 0.006) and 30 day (P = 0.028) mortality rates than the non-. Acinetobacter gen. sp. 2 group. The fatal outcome was independently associated with high SPAS II scores (P = 0.002), rapidly fatal underlying diseases (P = 0.002), bacteremia caused by Acinetobacter gen. sp. 2 (P = 0.01), inappropriate definitive antimicrobial therapy (P < 0.001), and severe sepsis (P < 0.001). Conclusion: Acinetobacter gen. sp. 2 bacteremia heralded a worse clinical outcome, and therefore the gen. sp. identification of ABC bacteremic isolates is justified.
AB - Objectives: Bacteremia due to Acinetobacter baumannii complex (ABC), which composed of four genomic species (gen. sp.), is a serious and potentially fatal condition. The epidemiology and outcome of such infections due to individual gen. sp. remain undefined. Methods: A retrospective study of patients with monomicrobial ABC bacteremia over six years was conducted at a medical center to determine the association of gen. sp. with clinical outcome. Results: Included were 291 patients with monomicrobial ABC bacteremia. Of them, 222 (76.3%) patients had bacteremia caused by gen. sp. 2, i.e. A. baumannii. The presence of multidrug-resistant phenotype was the only independent predictor of Acinetobacter gen. sp. 2 bacteremia (adjusted odd ratio, 7.5; 95% confidence interval, 3.8-14.7; P < 0.001). Patients with Acinetobacter gen. sp. 2 bacteremia had a higher sepsis-related (P = 0.006) and 30 day (P = 0.028) mortality rates than the non-. Acinetobacter gen. sp. 2 group. The fatal outcome was independently associated with high SPAS II scores (P = 0.002), rapidly fatal underlying diseases (P = 0.002), bacteremia caused by Acinetobacter gen. sp. 2 (P = 0.01), inappropriate definitive antimicrobial therapy (P < 0.001), and severe sepsis (P < 0.001). Conclusion: Acinetobacter gen. sp. 2 bacteremia heralded a worse clinical outcome, and therefore the gen. sp. identification of ABC bacteremic isolates is justified.
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U2 - 10.1016/j.jinf.2010.07.002
DO - 10.1016/j.jinf.2010.07.002
M3 - Article
C2 - 20624424
AN - SCOPUS:77955660163
SN - 0163-4453
VL - 61
SP - 219
EP - 227
JO - Journal of Infection
JF - Journal of Infection
IS - 3
ER -
