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Risk factors for mortality in Acinetobacter calcoaceticus-baumannii bacteraemia

Publication Type : Journal Article

Publisher : Asian Pacific Journal of Tropical Biomedicine

Source : Asian Pacific Journal of Tropical Biomedicine, Volume 2, Number 3 SUPPL., p.S1852-S1857 (2012)

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Keywords : Acinetobacter baumannii, Acinetobacter calcoaceticus, Acinetobacter infection, adult, age distribution, aged, antibiotic agent, antibiotic resistance, antibiotic therapy, article, artificial ventilation, bacterial colonization, bacterium isolate, bloodstream infection, bodily secretions, carbapenem, cefoperazone, ceftazidime, cerebrovascular accident, child, chronic obstructive lung disease, ciprofloxacin, colistin, creatinine, diabetes mellitus, disk diffusion, female, gentamicin, heart failure, human, India, infant, infection risk, intravascular catheter, kidney failure, length of stay, major clinical study, male, mixed infection, mortality, multidrug resistance, neutrophil count, observational study, phenotype, piperacillin, piperacillin plus tazobactam, preschool child, priority journal, prothrombin time, risk assessment, sulperazon, thrombocyte count, urea, urea blood level

Campus : Kochi

School : School of Medicine

Department : Microbiology, Pulmonary Medicine

Year : 2012

Abstract : pObjective: To determine the risk factors associated with mortality in Acinetobacter calcoaceticus-baumannii (Acb) complex blood stream infection. Methods: This was an observational study conducted in tertiary care hospital of South India. All patients with blood culture positive for Acb complex from January 2008 to December 2009 were included and a standardized abstraction form was used to abstract data. P value was calculated by Chi square test. Univariate analysis was done by using 2×2 tables and the variables with P value of lt;0.1 were further subjected to multivariate analysis. Multivariate analysis was done by logistic regression method. Results: After excluding the polymicrobial infections and duplicate isolates from the same patients, 81 cases were included in our study. Out of 81 patients, 20 (24.6%) patients had positive isolate from body secretion other than blood for Acb complex, majority were hospitalized in intensive care unit (74%), had indwelling vascular catheters (68%) and were mechanically ventilated (61%). Multi drug resistant phenotypes were seen in 56 (69.1%) isolates and among them 13 (16%) were resistant to carbapenems. Univariate analysis showed renal disease, diabetes mellitus, use of mechanical ventilation and absence of appropriate antibiotic therapy, leucopenia, thrombocytopenia and raised prothrombin time were related to increased mortality in Acb complex bacteraemia. However, in multivariate analysis independent risk factors for mortality in Acb complex bacteraemia were platelets of less than 1.5 lacks and inappropriate empirical antibiotics. Conclusions: Thrombocytopenia and absence of appropriate antibiotics were risk factors associated with mortality in Acb bacteraemia. Patients with blood culture showing Acb complex bacteraemia with above findings should be attended with aggressive management. Clinician of hospitals with high incidence of Acb complex bacteraemia, should predict the chances of such infection even prior to blood culture reports are available, and should initiate appropriate antibiotics according to their institution antibiogram. © 2012 Asian Pacific Tropical Biomedical Magazine./p

Cite this Research Publication : A. Aa Mehta, Kumar, V. Ab, Kumari, I. Ka, Nair, S. Gc, Dinesh, K. Rb, and Singh, S. Kd, “Risk factors for mortality in Acinetobacter calcoaceticus-baumannii bacteraemia”, Asian Pacific Journal of Tropical Biomedicine, vol. 2, pp. S1852-S1857, 2012.

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