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Volume 44, Number 3, June 2011

Predictors of mortality in surgical patients with Acinetobacter baumannii bacteremia


Su-Jung Chen, Tze-Fan Chao, Mei-Chun Chiang, Shu-Chen Kuo, Liang-Yu Chen, Dung-Hung Chiang, Ti Yin, Te-Li Chen, Chang-Phone Fung


Received: March 12, 2010    Revised: May 4, 2010    Accepted: July 27, 2010   

 

Corresponding author:

Division of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital, No. 201, Sec. 2,
Shih-Pai Rd, Taipei 11217, Taiwan.
E-mail address: tlchen@vghtpe.gov.tw (T.-L. Chen).
 



 

Background and purpose: 

Acinetobacter baumannii has emerged as an important pathogen of nosocomial infection. The aim of this study was to evaluate the predictors of poor outcome in surgical patients with A baumannii bacteremia.



 

Methods:

We retrospectively recruited a total of 50 patients who developed A baumannii bacteremia within 2 weeks after surgery during a 113-month period. The primary outcome for this study was all-cause 14-day mortality. Clinical and laboratory data, antimicrobial susceptibility, treatment, and Sequential Organ Failure Assessment (SOFA) score were evaluated as possible predictors of outcome.



 

Results:

The 14-day mortality was 20% and there was no association between type of surgery and mortality. The SOFA score was the only independent predictor of 14-day mortality after adjustment for other variables. The calibration was acceptable (Hosmer-Lemeshow χ2 = 3.65, p = 0.72) and the discrimination was good (area under the receiver operating characteristic curve: 0.80 ± 0.07, 95% confidence interval, 0.67–0.94). We found that a SOFA score ≥7 was a significant predictor of 14-day mortality in surgical patients with A baumannii bacteremia.



 

Conclusion:

The SOFA score assessed at the onset of bacteremia is a reliable tool for predicting 14-day mortality in surgical patients with A baumannii bacteremia.



 

Key words:

Acinetobacter baumannii, Bacteremia, Mortality, SOFA score, Surgical