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Incidence and risk factors for carbapenem- and multidrug-resistant Acinetobacter baumannii bacteremia in hematopoietic stem cell transplantation recipients

Authors
 Sun Bean Kim  ;  Yoo Hong Min  ;  June-Won Cheong  ;  Jin Seok Kim  ;  Soo Jeong Kim  ;  Nam Su Ku  ;  Su Jin Jeong  ;  Sang Hoon Han  ;  Jun Yong Choi  ;  Young Goo Song  ;  June Myung Kim 
Citation
 SCANDINAVIAN JOURNAL OF INFECTIOUS DISEASES, Vol.46(2) : 81-88, 2014 
Journal Title
SCANDINAVIAN JOURNAL OF INFECTIOUS DISEASES
ISSN
 0036-5548 
Issue Date
2014
MeSH
Acinetobacter Infections/epidemiology* ; Acinetobacter Infections/microbiology ; Acinetobacter Infections/mortality ; Acinetobacter Infections/pathology ; Acinetobacter baumannii/drug effects* ; Acinetobacter baumannii/isolation & purification ; Adult ; Bacteremia/epidemiology* ; Bacteremia/microbiology ; Bacteremia/mortality ; Bacteremia/pathology ; Case-Control Studies ; Cohort Studies ; Drug Resistance, Multiple, Bacterial* ; Female ; Hematopoietic Stem Cell Transplantation/adverse effects ; Humans ; Immunocompromised Host* ; Incidence ; Male ; Retrospective Studies ; Risk Factors ; Survival Analysis ; Tertiary Care Centers
Keywords
Hematopoietic stem cell transplantation ; Acinetobacter baumannii ; bacteremia ; multidrug resistance
Abstract
BACKGROUND: Bacteremia with multidrug-resistant (MDR) Acinetobacter baumannii with carbapenem resistance is an important healthcare-associated infection that increases morbidity and mortality in immunocompromised patients. The aim of this study was to assess the annual incidence and clinical characteristics of such bacteremia and to identify the risk factors for infection in hematopoietic stem cell transplantation (HSCT) recipients.
METHODS: A retrospective cohort and case-control study was conducted in 483 HSCT recipients between January 2005 and December 2011 at a single tertiary center. Thirty-eight control HSCT patients without evidence of post-transplant infection were matched with 19 patients with bacteremia due to MDR A. baumannii in a 2:1 ratio.
RESULTS: The total incidence of carbapenem-resistant-MDR A. baumannii bacteremia was 0.52 cases/10,000 patient-days. In most cases (17 of 19, 89.5%), bacteremia developed after engraftment. Pneumonia was the origin of bacteremia in all patients. Eighteen (94.7%) patients with bacteremia and 3 (8.3%) without bacteremia died. In multivariate regression analyses, the duration between admission and HSCT (odds ratio (OR) 2.19 per 1-day increase, p = 0.030) and a history of care in an intensive care unit after HSCT (OR 32.2, p = 0.021) were independent risk factors for the development of carbapenem-resistant-MDR A. baumannii bacteremia.
CONCLUSIONS: We report that carbapenem-resistant-MDR A. baumannii bacteremia in HSCT recipients is a fatal infectious complication and mainly develops after engraftment.
Full Text
http://informahealthcare.com/doi/abs/10.3109/00365548.2013.857042
DOI
10.3109/00365548.2013.857042
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Ku, Nam Su(구남수) ORCID logo https://orcid.org/0000-0002-9717-4327
Kim, Sun Bean(김선빈)
Kim, Soo Jeong(김수정) ORCID logo https://orcid.org/0000-0001-8859-3573
Kim, June Myung(김준명)
Kim, Jin Seok(김진석) ORCID logo https://orcid.org/0000-0001-8986-8436
Min, Yoo Hong(민유홍) ORCID logo https://orcid.org/0000-0001-8542-9583
Song, Young Goo(송영구) ORCID logo https://orcid.org/0000-0002-0733-4156
Jeong, Su Jin(정수진) ORCID logo https://orcid.org/0000-0003-4025-4542
Cheong, June-Won(정준원) ORCID logo https://orcid.org/0000-0002-1744-0921
Choi, Jun Yong(최준용) ORCID logo https://orcid.org/0000-0002-2775-3315
Han, Sang Hoon(한상훈) ORCID logo https://orcid.org/0000-0002-4278-5198
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/98002
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