Back to Search
Start Over
Excess mortality due to pandrug-resistant Acinetobacter baumannii infections in hospitalized patients.
- Source :
-
The Journal of hospital infection [J Hosp Infect] 2020 Nov; Vol. 106 (3), pp. 447-453. Date of Electronic Publication: 2020 Sep 11. - Publication Year :
- 2020
-
Abstract
- Background: Pandrug-resistant Acinetobacter baumannii (PDRAB) is increasingly being reported as a nosocomial pathogen worldwide, but determining its clinical impact is challenging.<br />Aim: To assess the spectrum of excess mortality attributable to PDRAB infection in acute care settings.<br />Methods: This four-year cohort study was conducted in a tertiary-care referral hospital in Greece to estimate excess in-hospital mortality due to PDRAB infection by comparing patients infected to those colonized with PDRAB by means of competing risks survival analysis.<br />Findings: The study cohort comprised 91 patients (median age: 67 years; 77% men). For most patients, PDRAB was first isolated in the intensive care unit (ICU) (N = 51; 57%) or following ICU discharge (N = 26; 29%). Overall in-hospital mortality was 68% (95% confidence interval (CI): 57.5-77.5%). PDRAB-infected patients (N = 62; 68%) and PDRAB-colonized patients (N = 29; 32%) had similar baseline characteristics, but the absolute excess risk of 30-day mortality in infected patients compared to colonized patients was 34% (95% CI: 14-54%). Multivariable competing risks regression showed that PDRAB infection significantly increased the daily hazard of 30-day in-hospital death (cause-specific hazard ratio (csHR): 3.10; 95% CI: 1.33-7.21) while simultaneously decreasing the daily rate of discharge (csHR: 0.24; 95% CI: 0.08-0.74), thereby leading to longer hospitalization. Stronger effects were observed for bloodstream infections.<br />Conclusion: New effective antimicrobials would be expected to prevent mortality in one of every three patients treated for PDRAB infection and reduce their length of hospitalization. However, available therapeutic options remain extremely limited and emphasis on preventing healthcare-associated transmission of PDRAB is ever more important.<br /> (Copyright © 2020 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.)
- Subjects :
- Acinetobacter Infections drug therapy
Acinetobacter baumannii drug effects
Acinetobacter baumannii pathogenicity
Aged
Anti-Bacterial Agents therapeutic use
Cohort Studies
Cross Infection microbiology
Cross Infection prevention & control
Female
Greece
Hospital Mortality
Hospitalization
Humans
Intensive Care Units statistics & numerical data
Male
Microbial Sensitivity Tests
Middle Aged
Acinetobacter Infections mortality
Anti-Bacterial Agents pharmacology
Cross Infection mortality
Drug Resistance, Multiple, Bacterial
Subjects
Details
- Language :
- English
- ISSN :
- 1532-2939
- Volume :
- 106
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- The Journal of hospital infection
- Publication Type :
- Academic Journal
- Accession number :
- 32927013
- Full Text :
- https://doi.org/10.1016/j.jhin.2020.09.009