Comparison of pneumonia- and non-pneumonia-related Acinetobacter baumannii bacteremia: Impact on empiric therapy and antibiotic resistance

Sing On Teng, Muh Yong Yen, Tsong Yih Ou, Fu Lun Chen, Fang Lan Yu, Wen Sen Lee

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Objective: Acinetobacter baumannii (AB) bacteremia has increasingly emerged as a nosocomial pathogen in healthcare settings, associated with high patient morbidity and mortality. The objective of this study was to compare clinical features, risk factors, treatment outcome, and antibiotic resistance in patients with pneumonia- and non-pneumonia-related AB bacteremia. Methods: We conducted a retrospective study in a tertiary teaching hospital in northern Taiwan. The medical records of the 141 episodes of hospital-acquired AB bacteremia between July 1, 2006 and June 30, 2012 were reviewed, and sorted into groups of AB bacteremia with (n = 59) and without pneumonia (n = 82). Results: The hospital-acquired pneumonia-related AB bacteremia group were found to be significantly more frequently treated in intensive care units (49.2%, p <0.001), but the AB bacteremia without pneumonia group were significantly more frequently treated on general wards (85.4%, p <0.001). Patients with pneumonia tended to be older than the nonpneumonia group (72.8 years vs. 65.2 years in mean age, p <0.01), and more likely to use mechanical ventilators (62.7% vs. 15.9 %, p <0.001). Pneumonia patients were found to receive broad-spectrum antibiotics significantly earlier than nonpneumonia patients (p <0.001). Compared to those without pneumonia, the patients with pneumonia had significantly higher incidence of antibiotic-resistance (p <0.05), longer hospital stay (p <0.01), and higher mortality rate (p <0.001). The incidence of multidrug-resistant AB was significantly higher in patients with pneumonia (p <0.05), and only colistin (p <0.01) and tigecycline (p <0.01) were significantly active against multidrug-resistant AB isolates. Conclusion: Pneumonia-related AB bacteremia has a worse outcome, more antibiotic resistance, and more comorbidity than the nonpneumonia group.

Original languageEnglish
Pages (from-to)525-530
Number of pages6
JournalJournal of Microbiology, Immunology and Infection
Volume48
Issue number5
DOIs
Publication statusPublished - Oct 1 2015

Fingerprint

Acinetobacter baumannii
Microbial Drug Resistance
Bacteremia
Pneumonia
Therapeutics
Colistin
Patients' Rooms
Mortality
Incidence
Mechanical Ventilators
Taiwan
Tertiary Care Centers
Teaching Hospitals
Medical Records
Intensive Care Units
Comorbidity
Length of Stay
Retrospective Studies
Anti-Bacterial Agents
Morbidity

Keywords

  • Acinetobacter baumannii
  • Antibiotic resistance
  • Bacteremia
  • Hospital-acquired pneumonia

ASJC Scopus subject areas

  • Microbiology (medical)
  • Immunology and Allergy
  • Immunology and Microbiology(all)
  • Infectious Diseases

Cite this

@article{89a352d22699407e94b2694aab7ea4bb,
title = "Comparison of pneumonia- and non-pneumonia-related Acinetobacter baumannii bacteremia: Impact on empiric therapy and antibiotic resistance",
abstract = "Objective: Acinetobacter baumannii (AB) bacteremia has increasingly emerged as a nosocomial pathogen in healthcare settings, associated with high patient morbidity and mortality. The objective of this study was to compare clinical features, risk factors, treatment outcome, and antibiotic resistance in patients with pneumonia- and non-pneumonia-related AB bacteremia. Methods: We conducted a retrospective study in a tertiary teaching hospital in northern Taiwan. The medical records of the 141 episodes of hospital-acquired AB bacteremia between July 1, 2006 and June 30, 2012 were reviewed, and sorted into groups of AB bacteremia with (n = 59) and without pneumonia (n = 82). Results: The hospital-acquired pneumonia-related AB bacteremia group were found to be significantly more frequently treated in intensive care units (49.2{\%}, p <0.001), but the AB bacteremia without pneumonia group were significantly more frequently treated on general wards (85.4{\%}, p <0.001). Patients with pneumonia tended to be older than the nonpneumonia group (72.8 years vs. 65.2 years in mean age, p <0.01), and more likely to use mechanical ventilators (62.7{\%} vs. 15.9 {\%}, p <0.001). Pneumonia patients were found to receive broad-spectrum antibiotics significantly earlier than nonpneumonia patients (p <0.001). Compared to those without pneumonia, the patients with pneumonia had significantly higher incidence of antibiotic-resistance (p <0.05), longer hospital stay (p <0.01), and higher mortality rate (p <0.001). The incidence of multidrug-resistant AB was significantly higher in patients with pneumonia (p <0.05), and only colistin (p <0.01) and tigecycline (p <0.01) were significantly active against multidrug-resistant AB isolates. Conclusion: Pneumonia-related AB bacteremia has a worse outcome, more antibiotic resistance, and more comorbidity than the nonpneumonia group.",
keywords = "Acinetobacter baumannii, Antibiotic resistance, Bacteremia, Hospital-acquired pneumonia",
author = "Teng, {Sing On} and Yen, {Muh Yong} and Ou, {Tsong Yih} and Chen, {Fu Lun} and Yu, {Fang Lan} and Lee, {Wen Sen}",
year = "2015",
month = "10",
day = "1",
doi = "10.1016/j.jmii.2014.06.011",
language = "English",
volume = "48",
pages = "525--530",
journal = "Journal of Microbiology, Immunology and Infection",
issn = "0253-2662",
publisher = "Elsevier Taiwan LLC",
number = "5",

}

TY - JOUR

T1 - Comparison of pneumonia- and non-pneumonia-related Acinetobacter baumannii bacteremia

T2 - Impact on empiric therapy and antibiotic resistance

AU - Teng, Sing On

AU - Yen, Muh Yong

AU - Ou, Tsong Yih

AU - Chen, Fu Lun

AU - Yu, Fang Lan

AU - Lee, Wen Sen

PY - 2015/10/1

Y1 - 2015/10/1

N2 - Objective: Acinetobacter baumannii (AB) bacteremia has increasingly emerged as a nosocomial pathogen in healthcare settings, associated with high patient morbidity and mortality. The objective of this study was to compare clinical features, risk factors, treatment outcome, and antibiotic resistance in patients with pneumonia- and non-pneumonia-related AB bacteremia. Methods: We conducted a retrospective study in a tertiary teaching hospital in northern Taiwan. The medical records of the 141 episodes of hospital-acquired AB bacteremia between July 1, 2006 and June 30, 2012 were reviewed, and sorted into groups of AB bacteremia with (n = 59) and without pneumonia (n = 82). Results: The hospital-acquired pneumonia-related AB bacteremia group were found to be significantly more frequently treated in intensive care units (49.2%, p <0.001), but the AB bacteremia without pneumonia group were significantly more frequently treated on general wards (85.4%, p <0.001). Patients with pneumonia tended to be older than the nonpneumonia group (72.8 years vs. 65.2 years in mean age, p <0.01), and more likely to use mechanical ventilators (62.7% vs. 15.9 %, p <0.001). Pneumonia patients were found to receive broad-spectrum antibiotics significantly earlier than nonpneumonia patients (p <0.001). Compared to those without pneumonia, the patients with pneumonia had significantly higher incidence of antibiotic-resistance (p <0.05), longer hospital stay (p <0.01), and higher mortality rate (p <0.001). The incidence of multidrug-resistant AB was significantly higher in patients with pneumonia (p <0.05), and only colistin (p <0.01) and tigecycline (p <0.01) were significantly active against multidrug-resistant AB isolates. Conclusion: Pneumonia-related AB bacteremia has a worse outcome, more antibiotic resistance, and more comorbidity than the nonpneumonia group.

AB - Objective: Acinetobacter baumannii (AB) bacteremia has increasingly emerged as a nosocomial pathogen in healthcare settings, associated with high patient morbidity and mortality. The objective of this study was to compare clinical features, risk factors, treatment outcome, and antibiotic resistance in patients with pneumonia- and non-pneumonia-related AB bacteremia. Methods: We conducted a retrospective study in a tertiary teaching hospital in northern Taiwan. The medical records of the 141 episodes of hospital-acquired AB bacteremia between July 1, 2006 and June 30, 2012 were reviewed, and sorted into groups of AB bacteremia with (n = 59) and without pneumonia (n = 82). Results: The hospital-acquired pneumonia-related AB bacteremia group were found to be significantly more frequently treated in intensive care units (49.2%, p <0.001), but the AB bacteremia without pneumonia group were significantly more frequently treated on general wards (85.4%, p <0.001). Patients with pneumonia tended to be older than the nonpneumonia group (72.8 years vs. 65.2 years in mean age, p <0.01), and more likely to use mechanical ventilators (62.7% vs. 15.9 %, p <0.001). Pneumonia patients were found to receive broad-spectrum antibiotics significantly earlier than nonpneumonia patients (p <0.001). Compared to those without pneumonia, the patients with pneumonia had significantly higher incidence of antibiotic-resistance (p <0.05), longer hospital stay (p <0.01), and higher mortality rate (p <0.001). The incidence of multidrug-resistant AB was significantly higher in patients with pneumonia (p <0.05), and only colistin (p <0.01) and tigecycline (p <0.01) were significantly active against multidrug-resistant AB isolates. Conclusion: Pneumonia-related AB bacteremia has a worse outcome, more antibiotic resistance, and more comorbidity than the nonpneumonia group.

KW - Acinetobacter baumannii

KW - Antibiotic resistance

KW - Bacteremia

KW - Hospital-acquired pneumonia

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DO - 10.1016/j.jmii.2014.06.011

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