Risk factors and outcomes of bloodstream infections with metallo-beta-lactamase-producing Acinetobacter
Authors
YEON-A KIM ; JUN YONG CHOI ; CHANG KI KIM ; CHANG OH KIM ; MYUNG SOO KIM ; SUK HOON CHOI ; BUM SIK CHIN ; SANG HOON HAN ; HAN SUNG LEE ; HEE KYOUNG CHOI ; SU JIN JEOUNG ; YOUNG GOO SONG ; JONG HWA YUM ; DONGEUN YONG ; KYUNGWON LEE ; JUNE MYUNG KIM
Citation
SCANDINAVIAN JOURNAL OF INFECTIOUS DISEASES, Vol.40(3) : 234-240, 2008
The spread of Gram-negative bacilli with acquired metallo-beta-lactamase (MBL) threatens the successful treatment of major nosocomial infections. The objective of this study was to evaluate the differences in the clinical characteristics of bacteremia caused by MBL-producing Acinetobacter species and MBL non-producing isolates. Two retrospective case-control studies were conducted using data on patients with Acinetobacter bacteremia, who were admitted between January 2001 and December 2005 at a 1500-bed, tertiary-care teaching hospital. Case group 1 (n=27) included patients from whom imipenem-resistant Acinetobacter was isolated in blood culture, and case group 2 (n=7) consisted of those patients from group 1 who yielded MBL-producing isolates. The control group (n=41) included patients from whom carbapenem-susceptible Acinetobacter isolates were isolated in blood culture. Multivariate analysis revealed that the independent risk factors for imipenem-resistant Acinetobacter bacteremia were neutropenia and prolonged use of carbapenem. The independent risk factors for MBL-producing Acinetobacter bacteremia were neutropenia and prolonged use of cephalosporins. The results of this study suggest that a prolonged use of cephalosporins may be associated with MBL-producing Acinetobacter bacteremia.