Journal
JOURNAL OF CLINICAL MEDICINE
Volume 9, Issue 1, Pages -Publisher
MDPI
DOI: 10.3390/jcm9010153
Keywords
Acinetobacter baumannii; appropriate therapy; bacteremia; mortality; polymicrobial infection
Categories
Funding
- Taipei Veterans General Hospital [V106B-002, V107C-037, V108C-012, VTA106-T-5-3, VTA107-T-3-2, VTA108-T-2-3]
- Tri-Service General Hospital [TSGH-C107-099, TSGH-E-109237, VTA108-T-2-2]
- Ministry of National Defense-Medical Affairs Bureau [MAB-107-095, MAB-108-038]
- Ministry of Science and Technology [MOST 105-2314-B-016-039-MY3, MOST 107-2314-B-075-066-MY3, MOST 107-2314-B-016-051-MY3, MOST 108-2314-B-016-029]
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This retrospective observational study assessed the differences between monomicrobial and polymicrobial A. baumannii bacteremia and identified possible independent risk factors for 14-day mortality. There were 379 patients with A. baumannii bacteremia admitted to a tertiary care center in northern Taiwan between August 2008 and July 2015 enrolled for data analysis. Among them, 89 patients (23.5%) had polymicrobial bacteremia and 290 patients (76.5%) had monomicrobial bacteremia. No significant difference in 14-day mortality was observed between patients with monomicrobial and polymicrobial A. baumannii bacteremia (26.9% vs. 29.2%, p = 0.77). Logistic regression controlled for confounders demonstrated that polymicrobial bacteremia was not an independent predictor of mortality, whereas appropriate antimicrobial therapy was independently associated with reduced mortality. Higher 14-day mortality rates were observed in the polymicrobial bacteremic patients with concomitant isolation of Escherichia coli, Pseudomonas aeruginosa, and Enterobacter spp. from the bloodstream. Compared with patients with monomicrobial multidrug-resistant A. baumannii (MDRAb) bacteremia, those with MDRAb concomitant with Gram-negative bacilli bacteremia had a worse outcome. Polymicrobial A. baumannii bacteremia was not associated with a higher 14-day mortality rate than that of monomicrobial A. baumannii bacteremia, although more deaths were observed when certain Gram-negative bacteria were concomitantly isolated. Appropriate antimicrobial therapy remains an important life-saving measure for A. baumannii bacteremic patients.
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