Bloodstream infections caused by carbapenem-resistant Acinetobacter baumannii: Clinical features, therapy and outcome from a multicenter study

ISGRI-SITA (Italian Study Group on Resistant Infections of the Società Italiana Terapia Antinfettiva)

Research output: Contribution to journalArticle

Abstract

Objectives: bloodstream infections (BSI) due to multidrug-resistant (MDR) Acinetobacter baumannii (AB) have been increasingly observed among hospitalized patients. Methods: prospective, observational study conducted among 12 large tertiary-care hospitals, across 7 Italian regions. From June 2017 to June 2018 all consecutive hospitalized patients with bacteremia due to MDR-AB were included and analyzed in the study. Results: During the study period 281 episodes of BSI due to MDR-AB were observed: 98 (34.8%) episodes were classified as primary bacteremias, and 183 (65.2%) as secondary bacteremias; 177 (62.9%) of them were associated with septic shock. Overall, 14-day mortality was observed in 172 (61.2%) patients, while 30-day mortality in 207 (73.6%) patients. On multivariate analysis, previous surgery, continuous renal replacement therapy, inadequate source control of infection, and pneumonia were independently associated with higher risk of septic shock. Instead, septic shock and Charlson Comorbidity Index >3 were associated with 14-day mortality, while adequate source control of infection and combination therapy with survival. Finally, septic shock, previous surgery, and aminoglycoside-containing regimen were associated with 30-day mortality, while colistin-containing regimen with survival. Conclusions: BSI caused by MDR-AB represents a difficult challenge for physicians, considering the high rates of septic shock and mortality associated with this infection.

Original languageEnglish
Pages (from-to)1-32
Number of pages32
JournalJournal of Infection
DOIs
Publication statusE-pub ahead of print - May 27 2019

Fingerprint

Acinetobacter baumannii
Carbapenems
Septic Shock
Multicenter Studies
Bacteremia
Mortality
Infection
Infection Control
Colistin
Therapeutics
Renal Replacement Therapy
Survival
Aminoglycosides
Tertiary Healthcare
Tertiary Care Centers
Observational Studies
Comorbidity
Pneumonia
Multivariate Analysis
Prospective Studies

Keywords

  • Acinetobacter
  • Bacteremia
  • Colistin
  • Multidrug-resistant
  • Septic shock

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

Cite this

Bloodstream infections caused by carbapenem-resistant Acinetobacter baumannii : Clinical features, therapy and outcome from a multicenter study. / ISGRI-SITA (Italian Study Group on Resistant Infections of the Società Italiana Terapia Antinfettiva).

In: Journal of Infection, 27.05.2019, p. 1-32.

Research output: Contribution to journalArticle

ISGRI-SITA (Italian Study Group on Resistant Infections of the Società Italiana Terapia Antinfettiva). / Bloodstream infections caused by carbapenem-resistant Acinetobacter baumannii : Clinical features, therapy and outcome from a multicenter study. In: Journal of Infection. 2019 ; pp. 1-32.
@article{df5d7ab1bb7240d6aca8e4654932a0de,
title = "Bloodstream infections caused by carbapenem-resistant Acinetobacter baumannii: Clinical features, therapy and outcome from a multicenter study",
abstract = "Objectives: bloodstream infections (BSI) due to multidrug-resistant (MDR) Acinetobacter baumannii (AB) have been increasingly observed among hospitalized patients. Methods: prospective, observational study conducted among 12 large tertiary-care hospitals, across 7 Italian regions. From June 2017 to June 2018 all consecutive hospitalized patients with bacteremia due to MDR-AB were included and analyzed in the study. Results: During the study period 281 episodes of BSI due to MDR-AB were observed: 98 (34.8{\%}) episodes were classified as primary bacteremias, and 183 (65.2{\%}) as secondary bacteremias; 177 (62.9{\%}) of them were associated with septic shock. Overall, 14-day mortality was observed in 172 (61.2{\%}) patients, while 30-day mortality in 207 (73.6{\%}) patients. On multivariate analysis, previous surgery, continuous renal replacement therapy, inadequate source control of infection, and pneumonia were independently associated with higher risk of septic shock. Instead, septic shock and Charlson Comorbidity Index >3 were associated with 14-day mortality, while adequate source control of infection and combination therapy with survival. Finally, septic shock, previous surgery, and aminoglycoside-containing regimen were associated with 30-day mortality, while colistin-containing regimen with survival. Conclusions: BSI caused by MDR-AB represents a difficult challenge for physicians, considering the high rates of septic shock and mortality associated with this infection.",
keywords = "Acinetobacter, Bacteremia, Colistin, Multidrug-resistant, Septic shock",
author = "{ISGRI-SITA (Italian Study Group on Resistant Infections of the Societ{\`a} Italiana Terapia Antinfettiva)} and Alessandro Russo and Matteo Bassetti and Giancarlo Ceccarelli and Novella Carannante and Losito, {Angela Raffaella} and Michele Bartoletti and Silvia Corcione and Guido Granata and Antonella Santoro and Giacobbe, {Daniele Roberto} and Maddalena Peghin and Antonio Vena and Francesco Amadori and Segala, {Francesco Vladimiro} and Maddalena Giannella and {Di Caprio}, Giovanni and Francesco Menichetti and {Del Bono}, Valerio and Cristina Mussini and Nicola Petrosillo and {De Rosa}, {Francesco Giuseppe} and Pierluigi Viale and Mario Tumbarello and Carlo Tascini and Claudio Viscoli and Mario Venditti",
year = "2019",
month = "5",
day = "27",
doi = "10.1016/j.jinf.2019.05.017",
language = "English",
pages = "1--32",
journal = "Journal of Infection",
issn = "0163-4453",
publisher = "W.B. Saunders Ltd",

}

TY - JOUR

T1 - Bloodstream infections caused by carbapenem-resistant Acinetobacter baumannii

T2 - Clinical features, therapy and outcome from a multicenter study

AU - ISGRI-SITA (Italian Study Group on Resistant Infections of the Società Italiana Terapia Antinfettiva)

AU - Russo, Alessandro

AU - Bassetti, Matteo

AU - Ceccarelli, Giancarlo

AU - Carannante, Novella

AU - Losito, Angela Raffaella

AU - Bartoletti, Michele

AU - Corcione, Silvia

AU - Granata, Guido

AU - Santoro, Antonella

AU - Giacobbe, Daniele Roberto

AU - Peghin, Maddalena

AU - Vena, Antonio

AU - Amadori, Francesco

AU - Segala, Francesco Vladimiro

AU - Giannella, Maddalena

AU - Di Caprio, Giovanni

AU - Menichetti, Francesco

AU - Del Bono, Valerio

AU - Mussini, Cristina

AU - Petrosillo, Nicola

AU - De Rosa, Francesco Giuseppe

AU - Viale, Pierluigi

AU - Tumbarello, Mario

AU - Tascini, Carlo

AU - Viscoli, Claudio

AU - Venditti, Mario

PY - 2019/5/27

Y1 - 2019/5/27

N2 - Objectives: bloodstream infections (BSI) due to multidrug-resistant (MDR) Acinetobacter baumannii (AB) have been increasingly observed among hospitalized patients. Methods: prospective, observational study conducted among 12 large tertiary-care hospitals, across 7 Italian regions. From June 2017 to June 2018 all consecutive hospitalized patients with bacteremia due to MDR-AB were included and analyzed in the study. Results: During the study period 281 episodes of BSI due to MDR-AB were observed: 98 (34.8%) episodes were classified as primary bacteremias, and 183 (65.2%) as secondary bacteremias; 177 (62.9%) of them were associated with septic shock. Overall, 14-day mortality was observed in 172 (61.2%) patients, while 30-day mortality in 207 (73.6%) patients. On multivariate analysis, previous surgery, continuous renal replacement therapy, inadequate source control of infection, and pneumonia were independently associated with higher risk of septic shock. Instead, septic shock and Charlson Comorbidity Index >3 were associated with 14-day mortality, while adequate source control of infection and combination therapy with survival. Finally, septic shock, previous surgery, and aminoglycoside-containing regimen were associated with 30-day mortality, while colistin-containing regimen with survival. Conclusions: BSI caused by MDR-AB represents a difficult challenge for physicians, considering the high rates of septic shock and mortality associated with this infection.

AB - Objectives: bloodstream infections (BSI) due to multidrug-resistant (MDR) Acinetobacter baumannii (AB) have been increasingly observed among hospitalized patients. Methods: prospective, observational study conducted among 12 large tertiary-care hospitals, across 7 Italian regions. From June 2017 to June 2018 all consecutive hospitalized patients with bacteremia due to MDR-AB were included and analyzed in the study. Results: During the study period 281 episodes of BSI due to MDR-AB were observed: 98 (34.8%) episodes were classified as primary bacteremias, and 183 (65.2%) as secondary bacteremias; 177 (62.9%) of them were associated with septic shock. Overall, 14-day mortality was observed in 172 (61.2%) patients, while 30-day mortality in 207 (73.6%) patients. On multivariate analysis, previous surgery, continuous renal replacement therapy, inadequate source control of infection, and pneumonia were independently associated with higher risk of septic shock. Instead, septic shock and Charlson Comorbidity Index >3 were associated with 14-day mortality, while adequate source control of infection and combination therapy with survival. Finally, septic shock, previous surgery, and aminoglycoside-containing regimen were associated with 30-day mortality, while colistin-containing regimen with survival. Conclusions: BSI caused by MDR-AB represents a difficult challenge for physicians, considering the high rates of septic shock and mortality associated with this infection.

KW - Acinetobacter

KW - Bacteremia

KW - Colistin

KW - Multidrug-resistant

KW - Septic shock

UR - http://www.scopus.com/inward/record.url?scp=85066630504&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85066630504&partnerID=8YFLogxK

U2 - 10.1016/j.jinf.2019.05.017

DO - 10.1016/j.jinf.2019.05.017

M3 - Article

AN - SCOPUS:85066630504

SP - 1

EP - 32

JO - Journal of Infection

JF - Journal of Infection

SN - 0163-4453

ER -