Influence of ACB complex genospecies on clinical outcomes in a U.S. hospital with high rates of multidrug resistance - 17/01/15
, Egon Ozer a, Maureen K. Bolon a, Alan R. Hauser a, bSummary |
Objectives |
Bacteria within the Acinetobacter calcoaceticus-Acinetobacter baumannii (ACB) complex commonly cause nosocomial infection and are often multidrug resistant. Advances in genospecies typing allow for speciation within the ACB complex; however, little is known about the effect of genospecies on patient outcomes.
Methods |
Adult patients with ACB complex bacteremia from Jan 2005–Oct 2012 were included. Bacterial isolates were speciated by rpoB gene sequence analysis, and clinical data were collected.
Results |
Of 147 patients with ACB complex bacteremia, 116 had A. baumannii (78.9%), 28 had Acinetobacter pittii (19.0%), and 3 had Acinetobacter nosocomialis (2.0%). A. baumannii bacteremia was associated with greater comorbidity and was more frequently multidrug resistant (79% vs. 16%, p < 0.01). Multidrug resistant A. baumannii but not susceptible A. baumannii was associated with worse outcomes compared to non-baumannii ACB complex bacteremia. Neither multidrug resistance nor genospecies was an independent predictor of mortality, but receipt of appropriate therapy was associated with decreased risk of mortality (OR, 0.13; 95% CI, 0.04–0.44; p < 0.01).
Conclusions |
A. baumannii bacteremia is associated with worse clinical outcomes than non-baumannii ACB complex bacteremia. The difference, however, appears to be related to multidrug resistance and attendant receipt of appropriate therapy rather than genospecies.
Le texte complet de cet article est disponible en PDF.Keywords : Multidrug resistance, Bacteremia, Acinetobacter calcoaceticus, Acinetobacter baumannii, Genome
Plan
Vol 70 - N° 2
P. 144-152 - février 2015 Retour au numéro
Article précédent
- Clinical characteristics and outcome of elderly patients with community-onset bacteremia
- Cristina Hernández, Csaba Fehér, Alex Soriano, Francesc Marco, Manel Almela, Nazaret Cobos-Trigueros, Cristina De La Calle, Laura Morata, Josep Mensa, Jose Antonio Martínez
- Amino acid alterations in fibronectin binding protein A (FnBPA) and bacterial genotype are associated with cardiac device related infection in Staphylococcus aureus bacteraemia
- Nina J. Hos, Siegbert Rieg, Winfried V. Kern, Daniel Jonas, Vance G. Fowler, Paul G. Higgins, Harald Seifert, Achim J. Kaasch
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?