Ten-Year Changes in Bloodstream Infection With Acinetobacter Baumannii Complex in Intensive Care Units in Eastern China: A Retrospective Cohort Study

被引：10

作者：

Meng, Xiao ^{[1
,2
]}

Fu, Jintao ^{[3
]}

Zheng, Yue ^{[4
,5
,6
]}

Qin, Weidong ^{[7
]}

Yang, Hongna ^{[8
]}

Cao, Dongming ^{[9
]}

Lu, Haining ^{[10
]}

Zhang, Lu ^{[11
]}

Du, Zhiguo ^{[12
]}

Pang, Jiaojiao ^{[4
,5
,6
]}

Li, Wei ^{[13
]}

Guo, Haipeng ^{[7
]}

Du, Juan ^{[7
]}

Li, Chen ^{[7
]}

Wu, Dawei ^{[10
]}

Wang, Hao ^{[7
,14
]}

机构：

[1] Shandong Univ, Cheeloo Coll Med, Qilu Hosp,Chinese Natl Hlth Commiss, Key Lab Cardiovasc Remodeling & Funct Res,Chinese, Jinan, Peoples R China

[2] Shandong Univ, Chinese Acad Med Sci, State & Shandong Prov Joint Key Lab Translat Card, Dept Cardiol,Qilu Hosp,Cheeloo Coll Med, Jinan, Peoples R China

[3] Jining Med Univ, Dept Crit Care Med, Yanzhou Branch, Affiliated Hosp, Jining, Peoples R China

[4] Shandong Univ, Shandong Prov Clin Res Ctr Emergency & Crit Care, Inst Emergency & Crit Care Med, Chest Pain Ctr,Qilu Hosp, Jinan, Peoples R China

[5] Shandong Univ, Dept Emergency Med, Qilu Hosp, Jinan, Peoples R China

[6] Shandong Univ, Key Lab Emergency & Crit Care Med Shandong Prov,Q, Key Lab Cardiopulm Cerebral Resuscitat Res Shando, Shandong Prov Engn Lab Emergency & Crit Care Med, Jinan, Peoples R China

[7] Shandong Univ, Dept Crit Care Med, Qilu Hosp, Jinan, Peoples R China

[8] Shandong First Med Univ, Shandong Prov Hosp, Dept Crit Care Med, Jinan, Peoples R China

[9] Shandong First Med Univ, Dept Crit Care Med, Liaocheng Peoples Hosp, Liaocheng, Shandong, Peoples R China

[10] Shandong Univ, Dept Crit Care Med, Qilu Hosp, Qingdao, Peoples R China

[11] Shandong Univ, Dept Crit Care Med, Hosp 2, Jinan, Peoples R China

[12] Jiaxiang Peoples Hosp, Dept Crit Care Med, Jining, Peoples R China

[13] Shandong Univ, Dept Clin Lab, Qilu Hosp, Jinan, Peoples R China

[14] Shandong Univ, Sch Basic Med Sci, Dept Pharmacol, Jinan, Peoples R China

来源：

FRONTIERS IN MEDICINE | 2021年 / 8卷

基金：

中国国家自然科学基金;

关键词：

Acinetobacter baumannii complex; bloodstream infection; antibiotic resistance; prognosis; eastern China; ANTIMICROBIAL THERAPY; NOSOCOMIAL INFECTION; EMPIRIC THERAPY; RISK-FACTORS; MORTALITY; SURVEILLANCE; RESISTANCE; TRENDS; IMPACT; DRUG;

D O I：

10.3389/fmed.2021.715213

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background: There is little evidence on the changing prevalence, microbiological profile, and outcome of nosocomial Acinetobacter baumannii complex (ABC)-caused bloodstream infection (ABCBSI) specified in intensive care units (ICUs) in long-term studies, especially in China. Objective: We aimed to investigate changes in incidence, antibiotic resistance, therapy, and prognosis of ABCBSI in ICUs in eastern China during 2009-2018. Methods: A multicenter retrospective cohort study was conducted, and microbiological and clinical data for patients with ABCBSI acquired in nine adult ICUs in eastern China from 2009 to 2018. Results: A total of 202 cases were enrolled. For the years 2009-2010, 2011-2012, 2013-2014, 2015-2016, and 2017-2018, the incidence of ABCBSI increased significantly, as did the percentage of pan-drug-resistant isolates and resistant rates to most of antimicrobial agents; the percentage of drug-sensitive isolates decreased (all P < 0.05). The frequency of treatment with carbapenems and tigecycline increased, and that of cephalosporins decreased. Compared with those in the first years (2009-2012), ABCBSI patients in the lattermost years (2017-2018) were less often treated with appropriate empirical therapy, more often underwent pneumonia-related ABCBSI and mechanical ventilation support, and had higher 28-day mortality rates. Multivariate Cox regression indicated that increase in the degree of ABC antibiotics resistance, pneumonia-related ABCBSI, and septic shock were risk factors of 28-day mortality and associated with significant lower survival days. Conclusions: The past decade has witnessed a marked increase in the incidence of ABCBSI and in antibiotic resistance, with increasing pneumonia-related infections and worrisome mortality in ICUs in China. Controlling increasing resistance and preventing nosocomial pneumonia may play important roles in combatting these infections.

引用

页数：11

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