MORTALITY IN PATIENTS WITH RESPIRATORY AND NON-RESPIRATORY CARBAPENEM RESISTANT-MULTIDRUG RESISTANT ACINETOBACTER INFECTIONS

Authors

  • Nosheen Nasir Aga Khan University
  • Syed Faisal Mahmood Aga Khan University

Abstract

Background: Mortality from carbapenem-multi-drug resistant Acinetobacter infections may vary according to site of infection. The objective of this study was to compare mortality in respiratory vs. non-respiratory infection with Carbapenem-Multi-drug Resistant Acinetobacter (C-MRAB). Methods: We conducted a prospective cohort study to compare mortality rate in patients with respiratory vs. non-respiratory infection (n=30 each). Results: Results showed that mortality was 40% in the respiratory group compared to 23% in non-respiratory group; the difference was not statistically significant (p=0.165, RR=1.71, CI=0.73-3.75). There was a significantly higher prior admission rate in patients with respiratory infection (p=0.028). Logistic regression did not reveal any modifier effect from other variables. Conclusion: This study showed no significant difference in mortality in patients with carbapenem-multi-drug resistant acinetobacter respiratory vs. non-respiratory infections.Keywords: Acinetobacter; Mortality; Respiratory; Acinetobacter baumannii; Pneumonia

References

Erbay A, Idil A, Gozel MG, Mumcuoglu I, Balaban N. Impact of early appropriate antimicrobial therapy on survival in Acinetobacter baumannii bloodstream infections. Int J Antimicrob Agents 2009;34(6):575–9.

Shete VB, Ghadage DP, Muley VA, Bhore AV. Multi-drug resistant Acinetobacter ventilator-associated pneumonia. Lung India 2010;27(4):217–20.

Fishbain J, Peleg AY. Treatment of Acinetobacter infections. Clin Infect Dis 2010;51(1):79–84.

Munoz-Price LS, Weinstein RA. Acinetobacter infection. N Engl J Med 2008;358(12):1271–81.

Hasan B, Perveen K, Olsen B, Zahra R. Emergence of carbapenem-resistant Acinetobacter baumannii in hospitals in Pakistan. J Med Microbiol 2014;63(Pt 1):50–5.

Khan MS, Siddiqui SZ, Haider S, Zafar A, Zafar F, Khan RN, et al. Infection control education: impact on ventilator-associated pneumonia rates in a public sector intensive care unit in Pakistan. Trans R Soc Trop Med Hyg 2009;103(8):807–11.

Peleg AY, Seifert H, Paterson DL. Acinetobacter baumannii: emergence of a successful pathogen. Clin Microbiol Rev 2008;21(3):538–82.

Seifert H, Strate A, Pulverer G. Nosocomial bacteremia due to Acinetobacter baumannii. Clinical features, epidemiology, and predictors of mortality. Medicine (Baltimore) 1995;74(6):340–9.

Lortholary O, Fagon JY, Hoi AB, Slama MA, Pierre J, Giral P, et al. Nosocomial acquisition of multiresistant Acinetobacter baumannii: risk factors and prognosis. Clin Infect Dis 1995;20(4):790–6.

Metan G, Sariguzel F, Sumerkan B. Factors influencing survival in patients with multi-drug-resistant Acinetobacter bacteraemia. Eur J Intern Med 2009;20(5):540–4.

Sunenshine RH, Wright MO, Maragakis LL, Harris AD, Song X, Hebden J, et al. Multidrug-resistant Acinetobacter infection mortality rate and length of hospitalization. Emerg Infect Dis 2007;13(1):97–103.

Coelho JM, Turton JF, Kaufmann ME, Glover J, Woodford N, Warner M, et al. Occurrence of carbapenem-resistant Acinetobacter baumannii clones at multiple hospitals in London and Southeast England. J Clin Microbiol 2006;44(10):3623–7.

Livermore DM, Hill RL, Thomson H, Charlett A, Turton JF, Pike R, et al. Antimicrobial treatment and clinical outcome for infections with carbapenem- and multiply-resistant Acinetobacter baumannii around London. Int J Antimicrob Agents 2010;35(1):19–24.

Hsueh PR, Teng LJ, Chen CY, Chen WH, Yu CJ, Ho SW, et al. Pandrug-resistant Acinetobacter baumannii causing nosocomial infections in a university hospital, Taiwan. Emerg Infect Dis 2002;8(8):827–32.

Chen HP, Chen TL, Lai CH, Fung CP, Wong WW, Yu KW, et al. Predictors of mortality in Acinetobacter baumannii bacteremia. J Microbiol Immunol Infect 2005;38(2):127–36.

Gurjar M, Saigal S, Baronia AK, Rao BP, Azim A, Poddar B, et al. Carbapenem-resistant Acinetobacter ventilator-associated pneumonia: Clinical characteristics and outcome. Indian J Crit Care Med 2013;17(3):129–34.

Lee SO, Kim NJ, Choi SH, Hyong Kim T, Chung JW, Woo JH, et al. Risk factors for acquisition of imipenem-resistant Acinetobacter baumannii: A case-control study. Antimicrob Agents Chemother 2004;48(1):224–8.

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Published

2017-06-25