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Natural prognosis of carbapenem-resistant Acinetobacter baumannii bacteremia in patients who did not receive appropriate antibiotic treatment: A retrospective multicenter study in Korea
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....
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer Health
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6221697/ https://www.ncbi.nlm.nih.gov/pubmed/30412128 http://dx.doi.org/10.1097/MD.0000000000012984 |
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author | Kim, Tark Lee, Eun Jung Park, Seong Yeon Yu, Shi Nae Lee, Yu Mi Park, Ki-Ho Park, Se Yoon Jeon, Min Hyok Choo, Eun Ju Kim, Tae Hyong Lee, Mi Suk |
author_facet | Kim, Tark Lee, Eun Jung Park, Seong Yeon Yu, Shi Nae Lee, Yu Mi Park, Ki-Ho Park, Se Yoon Jeon, Min Hyok Choo, Eun Ju Kim, Tae Hyong Lee, Mi Suk |
author_sort | Kim, Tark |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-6221697 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Wolters Kluwer Health |
record_format | MEDLINE/PubMed |
spelling | pubmed-62216972018-12-04 Natural prognosis of carbapenem-resistant Acinetobacter baumannii bacteremia in patients who did not receive appropriate antibiotic treatment: A retrospective multicenter study in Korea Kim, Tark Lee, Eun Jung Park, Seong Yeon Yu, Shi Nae Lee, Yu Mi Park, Ki-Ho Park, Se Yoon Jeon, Min Hyok Choo, Eun Ju Kim, Tae Hyong Lee, Mi Suk Medicine (Baltimore) Research Article 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. Wolters Kluwer Health 2018-10-26 /pmc/articles/PMC6221697/ /pubmed/30412128 http://dx.doi.org/10.1097/MD.0000000000012984 Text en Copyright © 2018 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by-nc-nd/4.0 This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0 |
spellingShingle | Research Article Kim, Tark Lee, Eun Jung Park, Seong Yeon Yu, Shi Nae Lee, Yu Mi Park, Ki-Ho Park, Se Yoon Jeon, Min Hyok Choo, Eun Ju Kim, Tae Hyong Lee, Mi Suk Natural prognosis of carbapenem-resistant Acinetobacter baumannii bacteremia in patients who did not receive appropriate antibiotic treatment: A retrospective multicenter study in Korea |
title | Natural prognosis of carbapenem-resistant Acinetobacter baumannii bacteremia in patients who did not receive appropriate antibiotic treatment: A retrospective multicenter study in Korea |
title_full | Natural prognosis of carbapenem-resistant Acinetobacter baumannii bacteremia in patients who did not receive appropriate antibiotic treatment: A retrospective multicenter study in Korea |
title_fullStr | Natural prognosis of carbapenem-resistant Acinetobacter baumannii bacteremia in patients who did not receive appropriate antibiotic treatment: A retrospective multicenter study in Korea |
title_full_unstemmed | Natural prognosis of carbapenem-resistant Acinetobacter baumannii bacteremia in patients who did not receive appropriate antibiotic treatment: A retrospective multicenter study in Korea |
title_short | Natural prognosis of carbapenem-resistant Acinetobacter baumannii bacteremia in patients who did not receive appropriate antibiotic treatment: A retrospective multicenter study in Korea |
title_sort | natural prognosis of carbapenem-resistant acinetobacter baumannii bacteremia in patients who did not receive appropriate antibiotic treatment: a retrospective multicenter study in korea |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6221697/ https://www.ncbi.nlm.nih.gov/pubmed/30412128 http://dx.doi.org/10.1097/MD.0000000000012984 |
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