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Multicenter Study
. 2018 Oct;97(43):e12984.
doi: 10.1097/MD.0000000000012984.

Natural prognosis of carbapenem-resistant Acinetobacter baumannii bacteremia in patients who did not receive appropriate antibiotic treatment: A retrospective multicenter study in Korea

Tark Kim  1 , Eun Jung Lee  2 , Seong Yeon Park  3 , Shi Nae Yu  4 , Yu Mi Lee  5 , Ki-Ho Park  5 , Se Yoon Park  2 , Min Hyok Jeon  4 , Eun Ju Choo  1 , Tae Hyong Kim  2 , Mi Suk Lee  5
Affiliations
Multicenter Study

Natural prognosis of carbapenem-resistant Acinetobacter baumannii bacteremia in patients who did not receive appropriate antibiotic treatment: A retrospective multicenter study in Korea

Tark Kim et al. Medicine (Baltimore). 2018 Oct.

Abstract

Carbapenem-resistant Acinetobacter baumannii (CRAB) infection is a major issues in current era. The aim of study was to investigate the natural prognosis and prognostic factors associated with 28-day mortality in patients with CRAB bacteremia who were not receiving appropriate antibiotic treatment.Adult patients with CRAB bacteremia were retrospectively identified between April 2012 and March 2015 at 5 tertiary hospitals in Republic of Korea. Patients who were transferred to another hospital within 28 days of onset of bacteremia and who receive appropriate antibiotics more than 48 hours were excluded. We investigated prognostic factors associated with 28-day mortality in patients with CRAB bacteremia without appropriate antibiotic treatment.Of enrolled 205 patients, 143 (69.8%) patients died within 28 days after blood culture. Of patients with 28-day mortality, 88.9% (127/143) of patients died within 5 days. Of 78 patients who survived more than 5 days, the 28-day mortality was 20.5% (16/78). Diabetes mellitus (adjusted odds ratio [aOR] 3.81, 95% confidence interval [95% CI] 1.19-12.20), immunocompromised (aOR 8.72, 95% CI 2.62-29.70), sequential organ failure assessment (SOFA) ≥ 10 (aOR 13.87, 95% CI 3.70-51.96), vasopressor use (aOR 7.03, 95% CI 1.79-27.60), and pneumonia (aOR 4.44, 95% CI 1.67-11.78) were found to be the factors independently associated with the 28-day mortality.The 28-day mortality in patients with CRAB bacteremia without appropriate treatment was high, although some patients could survive. Severity and underlying conditions were important prognostic factors in patients with CRAB bacteremia.

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
The study algorithm for the analysis of prognostic factors associated with 28-day mortality in patients with carbapenem-resistant Acinetobacter baumannii (CRAB) bacteremia who did not receive appropriate antibiotic treatment.
Figure 2
Figure 2
Kaplan–Meier survival curve of patients with carbapenem-resistant Acinetobacter baumannii (CRAB) bacteremia without appropriate antibiotic treatment. Figure B shows the comparison of survival between patients with any of risk factor and with none of risk factor.
See this image and copyright information in PMC

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