Malbaša Đekić1,2, T Dugandžija1,3, G Dragovac1,4, D Medić1,5, M Paut Kusturica6. 1. Department of Epidemiology, Faculty of Medicine Novi Sad, University of Novi Sad, Novi Sad, Serbia. 2. Department of Organization, Planning, Evaluation and Medical Informatics, Institute for Pulmonary Diseases of Vojvodina, Serbia. 3. Department of Epidemiology, Oncology Institute of Vojvodina, Sremska Kamenica, Serbia. 4. Center for Disease Prevention and Control, Serbia. 5. Center for microbiology, Institute of Public Health of Vojvodina, Serbia. 6. Department of Pharmacology and Toxicology, Faculty of Medicine Novi Sad, University of Novi Sad, Novi Sad, Serbia.
Abstract
BACKGROUND: Multidrug-resistant (MDR) isolates of Acinetobacter spp. have been reported worldwide. This study aimed to analyze clinical features and outcomes of intensive care unit (ICU) patients with MDR Acinetobacter spp. bacteremia and to determine factors influencing survival by using 30-day mortality as the primary endpoint. METHODS: A case-control study included a total of 164 patients with MDR Acinetobacter spp. bacteremia hospitalized in ICUs in Vojvodina Province, Serbia, from January 2013 through March 2016. Medical records were reviewed, and patients' demographic and clinical characteristics were collected. Predictors of 30-day mortality were identified by logistic regression analysis. Results: The overall 30-day mortality rate was 48.2 % (79 of 164 patients). Multivariate logistic regression analysis revealed that independent predictors of 30-day mortality were two or more co-morbidities, diabetes mellitus, and inappropriate use of antimicrobials. Conclusion: Early implementation of appropriate antimicrobial therapy, particularly in critically ill ICU patients with MDR Acinetobacter spp. bacteremia, with two or more co-morbidities and diabetes mellitus, can be crucial for survival. HIPPOKRATIA 2020, 24(1): 21-26. Copyright 2020, Hippokratio General Hospital of Thessaloniki.
BACKGROUND: Multidrug-resistant (MDR) isolates of Acinetobacter spp. have been reported worldwide. This study aimed to analyze clinical features and outcomes of intensive care unit (ICU) patients with MDR Acinetobacter spp. bacteremia and to determine factors influencing survival by using 30-day mortality as the primary endpoint. METHODS: A case-control study included a total of 164 patients with MDR Acinetobacter spp. bacteremia hospitalized in ICUs in Vojvodina Province, Serbia, from January 2013 through March 2016. Medical records were reviewed, and patients' demographic and clinical characteristics were collected. Predictors of 30-day mortality were identified by logistic regression analysis. Results: The overall 30-day mortality rate was 48.2 % (79 of 164 patients). Multivariate logistic regression analysis revealed that independent predictors of 30-day mortality were two or more co-morbidities, diabetes mellitus, and inappropriate use of antimicrobials. Conclusion: Early implementation of appropriate antimicrobial therapy, particularly in critically ill ICU patients with MDR Acinetobacter spp. bacteremia, with two or more co-morbidities and diabetes mellitus, can be crucial for survival. HIPPOKRATIA 2020, 24(1): 21-26. Copyright 2020, Hippokratio General Hospital of Thessaloniki.
Entities:
Keywords:
Acinetobacter spp; bacteremia; intensive care unit; multidrug-resistant; outcome