Prognosis of patients with Acinetobacter baumannii infection in the intensive care unit: A retrospective analysis

被引:20
作者
Xiao, Dong [1 ]
Wang, Lu [1 ]
Zhang, Daquan [1 ]
Xiang, Dongming [1 ]
Liu, Qi [1 ]
Xing, Xuezhong [2 ,3 ]
机构
[1] Peoples Hosp Xinjiang Uygur Autonomous Reg, Dept Crit Care Med 2, 91 Tianchi Rd, Urumqi 830001, Xinjiang, Peoples R China
[2] Chinese Acad Med Sci, Canc Hosp, Dept Crit Care Med, Beijing 100021, Peoples R China
[3] Peking Union Med Coll, Beijing 100021, Peoples R China
关键词
prognosis; retrospective analysis; critically ill patients; Acinetobacter baumannii; MORTALITY; BACTEREMIA;
D O I
10.3892/etm.2017.4137
中图分类号
R-3 [医学研究方法]; R3 [基础医学];
学科分类号
1001 ;
摘要
The present retrospective study aimed to investigate the prognostic factors for critically ill patients with an Acinetobacter baumannii (A. baumannii) infection. A total of 37 patients from the intensive care unit (ICU) were enrolled in the study. Data was collected from patients, including age, gender, ethnicity, A. baumannii infection status, concurrent infection status, prescribed antibiotics, Acute Physiology and Chronic Health Evaluation II (APACHE II) and sepsis-related organ failure assessment (SOFA) scores, procalcitonin level, site of infection, shock, sepsis and renal replacement therapy status. Univariate and multivariate analyses were performed to determine the prognostic factors for mortality. In total, 8 out of the 37 patients included in this trial did not survive, resulting in an ICU mortality rate of 21.6%. Univariate analysis indicated that, in comparison with the survival group, APACHE II and SOFA scores were significantly higher in the mortality group (P<0.002 and P<0.001, respectively). A larger number of patients with septic shock were detected in the mortality group in comparison with the survival group (n=4 and n=3, respectively), whereas a larger number of patients were infected with multidrug-resistant A. baumannii (MDRAB) in the survival group in comparison with the mortality group (51.9 and 14.3%, respectively). However, the prognosis was not significantly influenced by antibiotics administered, mixed infection or the site of infection. Multivariate analysis demonstrated that the APACHE II score was the only independent factor affecting the disease prognosis. Receiver operating characteristic curve analysis of the APACHE II score demonstrated that the area under the curve was 0.845 +/- 0.078. In patients with an APACHE II score of 15, the sensitivity and specificity predictions for mortality were 87.5% and 72.4%, respectively. The APACHE II score at diagnosis was the only independent factor found to assist in the prognosis of mortality for patients in the ICU with an A. baumannii infection. In conclusion, the results of the present study demonstrated that the APACHE II score may contribute towards the prognostic evaluation of patients in the ICU with an A. baumannii infection.
引用
收藏
页码:1630 / 1633
页数:4
相关论文
共 21 条
[1]  
[Anonymous], 2012, CHIN MED J
[2]  
Aydemir H, 2012, JPN J INFECT DIS, V65, P66
[3]  
Bacakoglu F, 2009, MIKROBIYOL BUL, V43, P575
[4]   Attributable mortality of Acinetobacter baumannii:: no longer a controversial issue [J].
Falagas, Matthew E. ;
Rafailidis, Petros I. .
CRITICAL CARE, 2007, 11 (03)
[5]   Risk factors for Acinetobacter baumannii nosocomial bacteremia in critically ill patients:: A cohort study [J].
García-Garmendia, JL ;
Ortiz-Leyba, C ;
Garnacho-Montero, J ;
Jiménez-Jiménez, FJ ;
Pérez-Paredes, C ;
Barrero-Almodóvar, AE ;
Gili-Miner, M .
CLINICAL INFECTIOUS DISEASES, 2001, 33 (07) :939-946
[6]   Attributable mortality of nosocomial Acinetobacter Bacteremia [J].
Grupper, Mordechai ;
Sprecher, Hanna ;
Mashiach, Tania ;
Finkelstein, Renato .
INFECTION CONTROL AND HOSPITAL EPIDEMIOLOGY, 2007, 28 (03) :293-298
[7]   Control of multidrug resistant bacteria in a tertiary care hospital in India [J].
Jaggi, Namita ;
Sissodia, Pushpa ;
Sharma, Lalit .
ANTIMICROBIAL RESISTANCE AND INFECTION CONTROL, 2012, 1
[8]   APACHE-II - A SEVERITY OF DISEASE CLASSIFICATION-SYSTEM [J].
KNAUS, WA ;
DRAPER, EA ;
WAGNER, DP ;
ZIMMERMAN, JE .
CRITICAL CARE MEDICINE, 1985, 13 (10) :818-829
[9]   Carbapenem resistance and mortality in patients with Acinetobacter baumannii infection: systematic review and meta-analysis [J].
Lemos, E. V. ;
de la Hoz, F. P. ;
Einarson, T. R. ;
McGhan, W. F. ;
Quevedo, E. ;
Castaneda, C. ;
Kawai, K. .
CLINICAL MICROBIOLOGY AND INFECTION, 2014, 20 (05) :416-423
[10]   2001 SCCM/ESICM/ACCP/ATS/SIS International Sepsis Definitions Conference [J].
Levy, MM ;
Fink, MP ;
Marshall, JC ;
Abraham, E ;
Angus, D ;
Cook, D ;
Cohen, J ;
Opal, SM ;
Vincent, JL ;
Ramsay, G .
CRITICAL CARE MEDICINE, 2003, 31 (04) :1250-1256