Risk factors of multidrug-resistant Acinetobacter baumannii recurrence after successful eradication in ventilated patients

Biomed J. 2016 Apr;39(2):130-8. doi: 10.1016/j.bj.2015.07.001. Epub 2016 Jun 10.

Abstract

Background: Clinically, multidrug-resistant Acinetobacter baumannii (MDR-AB) recurrence is found in some patients although identified as successfully eradicated. We aim to discover the characteristics of patients with MDR-AB recurrence in the respiratory tract.

Methods: We retrospectively collected 106 chronic respiratory failure patients with MDR-AB harvest in pulmonary secretion culture.

Results: MDR-AB was successfully eradicated in 69 patients. Diabetes mellitus (p = 0.030, odds ratio [OR]: 2.7, 95% confidence interval [CI]: 1.1-6.4) and acute respiratory distress syndrome (p = 0.001, OR = 4.8, 95% CI: 1.8-12.7) reduce the MDR-AB eradication rate. Besides, a classification of colonization or infection was made beyond the 69 MDR-AB eradicated patients. In the colonization group, diabetes mellitus (p = 0.009; OR = 5.1, 95% CI: 1.5-17.6) is the only independent factor to increase the recurrence rate. Glycated hemoglobin level is also analyzed for each group to investigate diabetes control effect, but no significant difference found.

Conclusions: Diabetes mellitus is a risk factor of MDR-AB recurrence among MDR-AB-colonized patients; the impact of localized pneumonia patch in MDR-AB-infected patients requires further study to be clarified.

Keywords: Chronic respiratory failure; Multidrug-resistant Acinetobacter baumannii; Recurrence; Risk factor.

MeSH terms

  • Acinetobacter Infections / drug therapy*
  • Acinetobacter baumannii / drug effects*
  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / administration & dosage
  • Anti-Bacterial Agents / therapeutic use*
  • Cross Infection / drug therapy*
  • Disease Eradication
  • Drug Resistance, Multiple, Bacterial / drug effects*
  • Female
  • Humans
  • Intensive Care Units
  • Male
  • Middle Aged
  • Retrospective Studies
  • Risk Factors

Substances

  • Anti-Bacterial Agents