Morbidity and mortality risk factors in emergency department patients with Acinetobacter baumannii bacteremia

Rui-Xue Sun; Priscilla Song; Joseph Walline; He Wang; Ying-Chun Xu; Hua-Dong Zhu; Xue-Zhong Yu; Jun Xu

doi:10.5847/wjem.j.1920-8642.2020.03.006

Morbidity and mortality risk factors in emergency department patients with Acinetobacter baumannii bacteremia

World J Emerg Med. 2020;11(3):164-168. doi: 10.5847/wjem.j.1920-8642.2020.03.006.

Authors

Rui-Xue Sun¹, Priscilla Song², Joseph Walline³, He Wang⁴, Ying-Chun Xu⁴, Hua-Dong Zhu¹, Xue-Zhong Yu¹, Jun Xu¹

Affiliations

¹ Emergency Department, Peking Union Medical College Hospital, Beijing 100010, China.
² Department of Anthropology, Washington University in Saint Louis, Saint Louis 63101, USA.
³ Division of Emergency Medicine, Saint Louis University, Saint Louis 63101, USA.
⁴ Laboratory Department, Peking Union Medical College Hospital, Beijing, China.

PMID: 32351649
PMCID: PMC7183915
DOI: 10.5847/wjem.j.1920-8642.2020.03.006

Abstract

Background: Acinetobacter baumannii (AB) bacteremia is an increasingly common and often fatal nosocomial infection. Identification of morbidity and mortality risk factors for AB bacteremia in emergency department (ED) patients may provide ways to improve the clinical outcomes of these patients.

Methods: The records for 51 patients with AB bacteremia and 51 patients without AB infection were collected and matched in a retrospective case-control study between 2013 and 2015 in a single-center ED. Risk factors were analyzed by Chi-square and multivariate logistic regression statistical models.

Results: A significant risk factor for morbidity was the presence of a central venous catheter (CVC) (P<0.001). The mortality rate for the 51 patients with AB bacteremia was 68.6%. Risk factors for mortality were the presence of a CVC (P=0.021) and an ED stay longer than two weeks (P=0.015).

Conclusion: AB infections lead to high morbidity and mortality. The presence of a CVC was associated with higher morbidity and mortality in patients with AB bacteremia. Avoiding CVC insertions may improve outcomes in ED patients with AB bacteremia.

Keywords: Acinetobacter baumannii; Bacteremia; Morbidity; Mortality.