Predictors of mortality of Acinetobacter baumannii infections: A 2-year prospective study in a Greek surgical intensive care unit

• Published in: American journal of infection control Vol. 38; no. 8; pp. 631 - 635
• Main Authors: Katsaragakis, Stilianos, MD, PhD, Markogiannakis, Haridimos, MD, PhD, Samara, Eleni, MD, Pachylaki, Nikoleta, MD, Theodoraki, Eleni-Maria, Xanthaki, Anna, MD, PhD, Toutouza, Marina, MD, PhD, Toutouzas, Konstantinos G., MD, PhD, Theodorou, Dimitrios, MD, PhD
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 01.10.2010; Elsevier; Mosby-Year Book, Inc
• Subjects: Acinetobacter baumannii; Acinetobacter baumannii infections; Acinetobacter Infections - epidemiology; Acinetobacter Infections - mortality; Aged; Aging; Anti-Bacterial Agents - therapeutic use; Bacteremia - epidemiology; Bacterial diseases; Bacterial sepsis; Biological and medical sciences; Cross Infection - epidemiology; Cross Infection - mortality; Drug resistance; Drug Resistance, Multiple, Bacterial; Enterococcus faecium; Enterococcus faecium bacteremia; Epidemiology. Vaccinations; General aspects; Gram-negative bacteria; Gram-Positive Bacterial Infections - epidemiology; Greece - epidemiology; Human bacterial diseases; Humans; Infection Control; Infectious Disease; Infectious diseases; Intensive care; Intensive Care Units - statistics & numerical data; Medical sciences; Morbidity; Mortality; multidrug resistance; Nosocomial infections; predictors; Prospective Studies; Risk Factors; surgical intensive care unit; Treatment Outcome; Greece; Europe; predictors; mortality; multidrug resistance; Acinetobacter baumannii infections; Enterococcus faecium bacteremia; surgical intensive care unit; Prognosis; Mortality; Neisseriaceae; Check; Bacteremia; Intensive care unit; Infection; Prevention; Streptococcaceae; Enterococcus faecium; Acinetobacter baumannii; Treatment; Surgery; Multiple resistance; Bacteriosis; Bacteria; Micrococcales; Predictive factor
• ISSN: 0196-6553; 1527-3296
• DOI: 10.1016/j.ajic.2010.01.009

Background Nosocomial infections are a frequent and continuously increasing problem worldwide, have a rapidly increasing multidrug resistance to antibiotics, and are associated with significant morbidity and mortality. Objective Our objectives were to evaluate Acinetobacter baumannii infection incidence in our surgical intensive care unit (SICU), the clinical features and outcome of these patients, and, particularly, to investigate predictors of A baumannii infection-related mortality. Methods Ours was a prospective study of all patients with ICU-acquired A baumannii infection from January 1, 2006, to December 31, 2007. Results Among 680 patients, 60 (8.8%) sustained A baumannii infection. Mean age was 68.4 ± 6.2 years, Acute Physiology and Chronic Health Evaluation (APACHE) II score on SICU admission 20.6 ± 8.1 and Sequential Organ Failure Assessment (SOFA) score on infection day 9.5 ± 4.2 (women: 50%). Multidrug resistance, morbidity, and mortality were 45%, 65%, and 46.6% (n = 28), respectively. In multivariate analysis, age ( P = .03; odds ratio [OR], 1.13; 95% confidence interval [CI]: 1.018-1.259), acute renal failure ( P = .001; OR, 17.9; 95% CI: 6.628-75.565), and thrombocytopenia ( P = .03; OR, 26.4; 95% CI: 1.234-56.926) complicating the infection and subsequent Enterococcus faecium bacteremia ( P = .01; OR, 3.5; 95% CI: 1.84-6.95) were mortality predictors. Conclusion A baumannii infections are frequent and associated with high drug multiresistance, morbidity, and mortality. Age, renal failure, thrombocytopenia, and subsequent E faecium bacteremia were predictors of A baumannii infection-associated mortality.