Risk factors for extensive drug-resistance and mortality in geriatric inpatients with bacteremia caused by Acinetobacter baumannii

Abstract

Background: The aim of this study was to explore the risk factors for developing bacteremia caused by extensive drug-resistant (XDR) Acinetobacter baumannii and the associated mortality in geriatric inpatients.

Methods: We conducted a retrospective study of 125 patients with A baumannii bacteremia between October 2008 and December 2013 at a medical center in China.

Results: The 30-day hospital mortality rate was 55.2%. XDR A baumannii was detected in 31.2% of all cases. A logistic regression analysis suggested that chronic obstructive pulmonary disease, a bedridden status, and central venous catheters were associated with bacteremia caused by XDR A baumannii, with adjusted odds ratios (aORs) and 95% confidence intervals (CIs) of 2.59 (1.01-6.64), 4.08 (1.39-12.01), and 9.52 (1.90-47.56), respectively. Furthermore, intensive care unit (ICU) stay, bacteremia caused by XDR A baumannii, concurrent fungal infection, and age (70-80 years old and >80 years old) were associated with mortality, with aORs and 95% CIs of 3.16 (1.29-7.73), 4.01 (1.46-11.04), 3.20 (1.28-7.98), 4.31 (1.44-12.92), and 5.46 (1.94-15.35), respectively.

Conclusion: Bacteremia is associated with a high 30-day hospital mortality rate in geriatric inpatients. Furthermore, ICU stay, bacteremia caused by XDR A baumannii, concurrent fungal infection, and age are associated with increased mortality in geriatric inpatients with A baumannii bacteremia.

Keywords: Acinetobacter baumannii; Bacteremia; Extensive drug resistance; Geriatric inpatients; Risk factors.