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Risk factors for occurrence and 30-day mortality for carbapenem-resistant Acinetobacter baumannii bacteremia in an intensive care unit.

Authors
 Song Yee Kim  ;  Ji Ye Jung  ;  Young Ae Kang  ;  Joo Eun Lim  ;  Eun Young Kim  ;  Sang Kook Lee  ;  Seon Cheol Park  ;  Kyung Soo Chung  ;  Byung Hoon Park  ;  Young Sam Kim  ;  Se Kyu Kim  ;  Joon Chang  ;  Moo Suk Park 
Citation
 JOURNAL OF KOREAN MEDICAL SCIENCE, Vol.27(8) : 939-947, 2012 
Journal Title
 JOURNAL OF KOREAN MEDICAL SCIENCE 
ISSN
 1011-8934 
Issue Date
2012
MeSH
Acinetobacter Infections/drug therapy ; Acinetobacter Infections/epidemiology ; Acinetobacter Infections/mortality* ; Acinetobacter baumannii/drug effects* ; Adult ; Aged ; Anti-Bacterial Agents/pharmacology* ; Anti-Bacterial Agents/therapeutic use ; Bacteremia/drug therapy ; Bacteremia/epidemiology ; Bacteremia/mortality* ; Carbapenems/pharmacology* ; Carbapenems/therapeutic use ; Case-Control Studies ; Drug Resistance, Multiple, Bacterial ; Female ; Humans ; Immunocompromised Host ; Intensive Care Units ; Male ; Middle Aged ; Odds Ratio ; Renal Insufficiency/etiology ; Retrospective Studies ; Risk Factors ; Survival Rate ; Time Factors
Keywords
Acinetobacter baumannii ; Bacteremia ; Drug Resistance, Multiple ; Intensive Care Units ; Mortality ; Risk Factors
Abstract
To assess the risk factors for carbapenem-resistant Acinetobacter baumannii (CRAB) bacteremia and for 30-day mortality in patients with CRAB bacteremia in the intensive care unit (ICU), we conducted a retrospective study in the ICU at Severance Hospital in Korea from January 2008 to December 2009. Patients who acquired CRAB bacteremia in the ICU were enrolled as the case group and patients whose specimens of blood culture, sputum/endotracheal aspirate and urine revealed no AB were enrolled as controls. The case group comprised 106 patients and 205 patients were included as controls. Risk factors independently associated with CRAB bacteremia included prior chemotherapy or radiotherapy treatment (Odds ratio [OR], 3.6; P = 0.003), recent central venous catheter insertion (OR, 5.7; P < 0.001) or abdominal drainage insertion (OR, 21.9; P = 0.004), the number of antibiotics treated with (OR, 1.3; P = 0.016), and respiratory failure in the ICU (OR, 2.5; P = 0.035). The 30-day mortality was 79.8%. Renal failure during ICU stay was independently associated with 30-day mortality (OR, 3.7; P = 0.047). It is important to minimize invasive procedures, and to restrict excessive use of antibiotics, especially in immunocompromised patients, in order to prevent the development of CRAB bacteremia. Greater concern for CRAB bacteremia patients is needed when renal failure develops during ICU stay.
Files in This Item:
T201203245.pdf Download
DOI
22876063
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Young Ae(강영애) ORCID logo https://orcid.org/0000-0002-7783-5271
Kim, Se Kyu(김세규)
Kim, Song Yee(김송이) ORCID logo https://orcid.org/0000-0001-8627-486X
Kim, Young Sam(김영삼) ORCID logo https://orcid.org/0000-0001-9656-8482
Kim, Eun Young(김은영) ORCID logo https://orcid.org/0000-0002-3281-5744
Park, Moo Suk(박무석) ORCID logo https://orcid.org/0000-0003-0820-7615
Park, Byung Hoon(박병훈)
Park, Seon Cheol(박선철)
Lee, Sang Kook(이상국)
Lim, Ju Eun(임주은)
Chang, Joon(장준) ORCID logo https://orcid.org/0000-0003-4542-6841
Jung, Kyung Soo(정경수) ORCID logo https://orcid.org/0000-0003-1604-8730
Jung, Ji Ye(정지예) ORCID logo https://orcid.org/0000-0003-1589-4142
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/90903
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