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Volume 41, Number 5, October 2008

Risk factors for mortality in patients with Acinetobacter baumannii bloodstream infection with genotypic species identification


Dung-Hung Chiang, Chien-Chun Wang, Han-Yueh Kuo, Hsin-Pai Chen, Te-Li Chen, Fu-Der Wang, Wen-Long Cho, Cheng-Yi Liu
Section of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital; I-Lan Hospital, I-Lan; Section of General Medicine, Department of Medicine, Taipei Veterans General Hospital; and Institute of Tropical Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan

Received: May 12, 2007    Revised: July 14, 2007    Accepted: July 31, 2007   

 

Corresponding author:

Te-Li Chen, Section of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Road, Taipei 112, Taiwan. E-mail: Te-Li Chen This e-mail address is being protected from spam bots, you need JavaScript enabled to view it
 



 

Background and purpose: 

Acinetobacter baumannii is an increasingly common nosocomial infection with a high mortality rate. Identification of predictor factors of mortality from A. baumannii infection is important for the implementation of therapeutic management for patients with higher risk. However, many studies have reported data for Acinetobacter calcoaceticus-A. baumannii complex, which might lead to an uncertainty of results. In this study, we aimed to identify the predictive factors for mortality of patients infected with true A. baumannii that had been precisely identified by genotypic methodology.
 



 

Methods:

Sixty seven patients with documented A. baumannii bacteremia were identified from a medical center in northern Taiwan during the period between February 1998 and February 2001. The patients’ medical records were retrospectively reviewed.
 



 

Results:

The risk factors associated with mortality in patients with A. baumannii bacteremia were underlying disease with malignancy, end-stage renal disease, and inappropriate antibiotic therapy. Laboratory variables, such as creatinine level, were also associated with poor prognosis by multivariate analysis.
 



 

Conclusion:

Increased serum creatinine level, malignancy and inappropriate therapy within 3 days were related to increased mortality in patients with A. baumannii bloodstream infection. Physicians should be aware of patients with poor prognostic factors and initiate prompt strategies, including appropriate antimicrobial therapy, in order to reduce mortality.



 

Key words:

Acinetobacter baumannii; Bacteremia; Mortality; Risk factors; Sequence analysis, DNA

 



 

J Microbiol Immunol Infect. 2008;41:397-402.