Factors Influencing Mortality in Patients With Multidrug-Resistant Acinetobacter baumannii Infection

Abstract

PURPOSE: Multidrug-resistant (MDR) Acinetobacter baumannii (Acb) is a rapidly emerging pathogen in healthcare settings. The aim of this study was to evaluate the predictors of poor outcome in patients with MDR Acb. METHODS: An isolate was described as pan-resistant if it was resistant to all commonly tested antibiotics except colistin. MDR Acb isolates were defined as those resistant to more than three classes of antibiotics. RESULTS: In this retrospective cohort study, 73 patients with 241 Acb isolates were obtained between January 2011 and January 2013 in Celal Bayar University Chest disease clinic. In the present study, the 30-day mortality rate was 57,5% (42 patients). Of 241 Acb isolates, 108 (44,8%) were MDR, 62 (25,7%) were pan-resistant, and 71 (29,5%) were non-MDR. The non-MDR isolates were used as the control group. Mortality was significantly higher in patients with MDR Acb infection (p<0.05). The factors significantly associated with multidrug resistance included presence of chronic lung disease, renal failure, mechanical ventilation, hospitalization previous month, isolation of Acb after 5 days, flora of localization where patient hospitalized and inappropriate antimicrobial therapy. The factors associated with mortality in patients with MDR Acb infection in this study were:renal failure, respiratory failure, cerebrovascular accident, use of more than two invasive procedures, wide specturum antiboiotic usage before hospitalization, and inappropriate antimicrobial treatment. CONCLUSIONS: Acb has emerged as an important nosocomial pathogen and infections due to MDR strains have been difficult to control, especially in intensive care units and mortality rate in Acinetobacter baumannii infection was found high.