Acinetobacter baumannii bloodstream infection: Clinical features and antimicrobial susceptibilities of isolates

S. W. Lai, K. C. Ng, W. L. Yu, C. S. Liu, M. M. Lai, C. C. Lin

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

The number of nosocomial infections caused by Acinetobacter baumannii has increased in recent years. The purposes of this study are to discover the risk factors of transmission to prevent the nosocomial infection of A. baumannii. We retrospectively studied 36 patients with A. baumannii bacteremia at China Medical College Hospital from January 1996 to December 1997. There were 23 males and 13 females. All bacteremia were acquired nosocomially. Malignancy (n = 8) and intracranial hemorrhage (n = 6) were the most common underlying diseases. Only one patient on arterial line disclosed intraarterial catheter-related A. baumannii bacteremia and 3 patients had evidence of A. baumannii pneumonia. Twenty-one patients (58%) had central venous catheters in place at the onset of bacteremia, but none was proven to be catheter-related infection. There were 32 patients (89%) with unknown portal of entry. Multivariate logistic regression analysis revealed that potential risk factors related to A. baumannii bacteremia were prior antimicrobial therapy (P <0.05). The most common clinical features of A. baumannii bacteremia were, in descending order, fever, leukocytosis, thrombocytopenia and hypotension. Eleven patients (30.6%) died directly from A. baumannii bacteremia. All isolates were resistant to ampicillin, cephalothin, cefonicid and moxalactam. The most alarming evidence was that 19% of isolates showed resistance to imipenem. Our findings emphasized that A. baumannii bacteremia had the following characteristics: usually acquired nosocomially, unknown portal of entry, and high multiresistance, especially the increasing resistance rate to imipenem. Imipenem must be reserved as a last-line agent to treat A. baumannii infections, so we want to suggest that the treatment of choice for A. baumannii is gentamicin, amikacin or ceftazidime.

Original languageEnglish
Pages (from-to)406-413
Number of pages8
JournalKaohsiung Journal of Medical Sciences
Volume15
Issue number7
Publication statusPublished - 1999
Externally publishedYes

Fingerprint

Acinetobacter baumannii
Bacteremia
Infection
Imipenem
Cross Infection
Cefonicid
Acinetobacter Infections
Moxalactam
Cephalothin
Catheter-Related Infections
Vascular Access Devices
Ceftazidime
Amikacin
Central Venous Catheters
Intracranial Hemorrhages
Leukocytosis
Ampicillin
Gentamicins
Thrombocytopenia
Hypotension

Keywords

  • Acinetobacter baumannii
  • Nosocomial infection
  • Resistance

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Acinetobacter baumannii bloodstream infection : Clinical features and antimicrobial susceptibilities of isolates. / Lai, S. W.; Ng, K. C.; Yu, W. L.; Liu, C. S.; Lai, M. M.; Lin, C. C.

In: Kaohsiung Journal of Medical Sciences, Vol. 15, No. 7, 1999, p. 406-413.

Research output: Contribution to journalArticle

@article{b5285518b9994d8ab1c48cc912747309,
title = "Acinetobacter baumannii bloodstream infection: Clinical features and antimicrobial susceptibilities of isolates",
abstract = "The number of nosocomial infections caused by Acinetobacter baumannii has increased in recent years. The purposes of this study are to discover the risk factors of transmission to prevent the nosocomial infection of A. baumannii. We retrospectively studied 36 patients with A. baumannii bacteremia at China Medical College Hospital from January 1996 to December 1997. There were 23 males and 13 females. All bacteremia were acquired nosocomially. Malignancy (n = 8) and intracranial hemorrhage (n = 6) were the most common underlying diseases. Only one patient on arterial line disclosed intraarterial catheter-related A. baumannii bacteremia and 3 patients had evidence of A. baumannii pneumonia. Twenty-one patients (58{\%}) had central venous catheters in place at the onset of bacteremia, but none was proven to be catheter-related infection. There were 32 patients (89{\%}) with unknown portal of entry. Multivariate logistic regression analysis revealed that potential risk factors related to A. baumannii bacteremia were prior antimicrobial therapy (P <0.05). The most common clinical features of A. baumannii bacteremia were, in descending order, fever, leukocytosis, thrombocytopenia and hypotension. Eleven patients (30.6{\%}) died directly from A. baumannii bacteremia. All isolates were resistant to ampicillin, cephalothin, cefonicid and moxalactam. The most alarming evidence was that 19{\%} of isolates showed resistance to imipenem. Our findings emphasized that A. baumannii bacteremia had the following characteristics: usually acquired nosocomially, unknown portal of entry, and high multiresistance, especially the increasing resistance rate to imipenem. Imipenem must be reserved as a last-line agent to treat A. baumannii infections, so we want to suggest that the treatment of choice for A. baumannii is gentamicin, amikacin or ceftazidime.",
keywords = "Acinetobacter baumannii, Nosocomial infection, Resistance",
author = "Lai, {S. W.} and Ng, {K. C.} and Yu, {W. L.} and Liu, {C. S.} and Lai, {M. M.} and Lin, {C. C.}",
year = "1999",
language = "English",
volume = "15",
pages = "406--413",
journal = "Gaoxiong yi xue ke xue za zhi = The Kaohsiung journal of medical sciences",
issn = "1607-551X",
publisher = "高雄醫學大學",
number = "7",

}

TY - JOUR

T1 - Acinetobacter baumannii bloodstream infection

T2 - Clinical features and antimicrobial susceptibilities of isolates

AU - Lai, S. W.

AU - Ng, K. C.

AU - Yu, W. L.

AU - Liu, C. S.

AU - Lai, M. M.

AU - Lin, C. C.

PY - 1999

Y1 - 1999

N2 - The number of nosocomial infections caused by Acinetobacter baumannii has increased in recent years. The purposes of this study are to discover the risk factors of transmission to prevent the nosocomial infection of A. baumannii. We retrospectively studied 36 patients with A. baumannii bacteremia at China Medical College Hospital from January 1996 to December 1997. There were 23 males and 13 females. All bacteremia were acquired nosocomially. Malignancy (n = 8) and intracranial hemorrhage (n = 6) were the most common underlying diseases. Only one patient on arterial line disclosed intraarterial catheter-related A. baumannii bacteremia and 3 patients had evidence of A. baumannii pneumonia. Twenty-one patients (58%) had central venous catheters in place at the onset of bacteremia, but none was proven to be catheter-related infection. There were 32 patients (89%) with unknown portal of entry. Multivariate logistic regression analysis revealed that potential risk factors related to A. baumannii bacteremia were prior antimicrobial therapy (P <0.05). The most common clinical features of A. baumannii bacteremia were, in descending order, fever, leukocytosis, thrombocytopenia and hypotension. Eleven patients (30.6%) died directly from A. baumannii bacteremia. All isolates were resistant to ampicillin, cephalothin, cefonicid and moxalactam. The most alarming evidence was that 19% of isolates showed resistance to imipenem. Our findings emphasized that A. baumannii bacteremia had the following characteristics: usually acquired nosocomially, unknown portal of entry, and high multiresistance, especially the increasing resistance rate to imipenem. Imipenem must be reserved as a last-line agent to treat A. baumannii infections, so we want to suggest that the treatment of choice for A. baumannii is gentamicin, amikacin or ceftazidime.

AB - The number of nosocomial infections caused by Acinetobacter baumannii has increased in recent years. The purposes of this study are to discover the risk factors of transmission to prevent the nosocomial infection of A. baumannii. We retrospectively studied 36 patients with A. baumannii bacteremia at China Medical College Hospital from January 1996 to December 1997. There were 23 males and 13 females. All bacteremia were acquired nosocomially. Malignancy (n = 8) and intracranial hemorrhage (n = 6) were the most common underlying diseases. Only one patient on arterial line disclosed intraarterial catheter-related A. baumannii bacteremia and 3 patients had evidence of A. baumannii pneumonia. Twenty-one patients (58%) had central venous catheters in place at the onset of bacteremia, but none was proven to be catheter-related infection. There were 32 patients (89%) with unknown portal of entry. Multivariate logistic regression analysis revealed that potential risk factors related to A. baumannii bacteremia were prior antimicrobial therapy (P <0.05). The most common clinical features of A. baumannii bacteremia were, in descending order, fever, leukocytosis, thrombocytopenia and hypotension. Eleven patients (30.6%) died directly from A. baumannii bacteremia. All isolates were resistant to ampicillin, cephalothin, cefonicid and moxalactam. The most alarming evidence was that 19% of isolates showed resistance to imipenem. Our findings emphasized that A. baumannii bacteremia had the following characteristics: usually acquired nosocomially, unknown portal of entry, and high multiresistance, especially the increasing resistance rate to imipenem. Imipenem must be reserved as a last-line agent to treat A. baumannii infections, so we want to suggest that the treatment of choice for A. baumannii is gentamicin, amikacin or ceftazidime.

KW - Acinetobacter baumannii

KW - Nosocomial infection

KW - Resistance

UR - http://www.scopus.com/inward/record.url?scp=0032806856&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0032806856&partnerID=8YFLogxK

M3 - Article

C2 - 10465922

AN - SCOPUS:0032806856

VL - 15

SP - 406

EP - 413

JO - Gaoxiong yi xue ke xue za zhi = The Kaohsiung journal of medical sciences

JF - Gaoxiong yi xue ke xue za zhi = The Kaohsiung journal of medical sciences

SN - 1607-551X

IS - 7

ER -