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Is Polymicrobial Bacteremia an Independent Risk Factor for Mortality in Acinetobacter baumannii Bacteremia?
J Clin Med 2020; 9(1)JC

Abstract

This retrospective observational study assessed the differences between monomicrobial and polymicrobial A. baumannii bacteremia and identified possible independent risk factors for 14-day mortality. There were 379 patients with A. baumannii bacteremia admitted to a tertiary care center in northern Taiwan between August 2008 and July 2015 enrolled for data analysis. Among them, 89 patients (23.5%) had polymicrobial bacteremia and 290 patients (76.5%) had monomicrobial bacteremia. No significant difference in 14-day mortality was observed between patients with monomicrobial and polymicrobial A. baumannii bacteremia (26.9% vs. 29.2%, p = 0.77). Logistic regression controlled for confounders demonstrated that polymicrobial bacteremia was not an independent predictor of mortality, whereas appropriate antimicrobial therapy was independently associated with reduced mortality. Higher 14-day mortality rates were observed in the polymicrobial bacteremic patients with concomitant isolation of Escherichia coli, Pseudomonas aeruginosa, and Enterobacter spp. from the bloodstream. Compared with patients with monomicrobial multidrug-resistant A. baumannii (MDRAb) bacteremia, those with MDRAb concomitant with Gram-negative bacilli bacteremia had a worse outcome. Polymicrobial A. baumannii bacteremia was not associated with a higher 14-day mortality rate than that of monomicrobial A. baumannii bacteremia, although more deaths were observed when certain Gram-negative bacteria were concomitantly isolated. Appropriate antimicrobial therapy remains an important life-saving measure for A. baumannii bacteremic patients.

Authors+Show Affiliations

Division of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan.Division of Infectious Diseases, Department of Medicine, Taipei City Hospital Renai Branch, Taipei 10629, Taiwan.Division of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan.Department of Emergency Medicine, Taipei Veterans General Hospital, Taipei 11217, Taiwan.Department of Emergency Medicine, Taipei Veterans General Hospital, Taipei 11217, Taiwan.National Institute of Infectious Diseases and Vaccinology, National Health Research Institute, Maoli County 35053, Taiwan.Division of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan.Graduate Institute of Life Sciences, National Defense Medical Center, Taipei 11490, Taiwan. Division of Infectious Diseases, Taipei Veterans General Hospital, Taipei 11217, Taiwan.Division of Infectious Diseases, Taipei Veterans General Hospital, Taipei 11217, Taiwan. Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei 11221, Taiwan.Department of Emergency Medicine, Taipei Veterans General Hospital, Taipei 11217, Taiwan. Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei 11221, Taiwan.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31935954

Citation

Wang, Yung-Chih, et al. "Is Polymicrobial Bacteremia an Independent Risk Factor for Mortality in Acinetobacter Baumannii Bacteremia?" Journal of Clinical Medicine, vol. 9, no. 1, 2020.
Wang YC, Ku WW, Yang YS, et al. Is Polymicrobial Bacteremia an Independent Risk Factor for Mortality in Acinetobacter baumannii Bacteremia? J Clin Med. 2020;9(1).
Wang, Y. C., Ku, W. W., Yang, Y. S., Kao, C. C., Kang, F. Y., Kuo, S. C., ... Lee, A. Y. (2020). Is Polymicrobial Bacteremia an Independent Risk Factor for Mortality in Acinetobacter baumannii Bacteremia? Journal of Clinical Medicine, 9(1), doi:10.3390/jcm9010153.
Wang YC, et al. Is Polymicrobial Bacteremia an Independent Risk Factor for Mortality in Acinetobacter Baumannii Bacteremia. J Clin Med. 2020 Jan 6;9(1) PubMed PMID: 31935954.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Is Polymicrobial Bacteremia an Independent Risk Factor for Mortality in Acinetobacter baumannii Bacteremia? AU - Wang,Yung-Chih, AU - Ku,Wen-Wei, AU - Yang,Ya-Sung, AU - Kao,Chih-Chun, AU - Kang,Fang-Yu, AU - Kuo,Shu-Chen, AU - Chiu,Chun-Hsiang, AU - Chen,Te-Li, AU - Wang,Fu-Der, AU - Lee,And Yi-Tzu, Y1 - 2020/01/06/ PY - 2019/12/02/received PY - 2019/12/28/revised PY - 2019/12/31/accepted PY - 2020/1/16/entrez KW - Acinetobacter baumannii KW - appropriate therapy KW - bacteremia KW - mortality KW - polymicrobial infection JF - Journal of clinical medicine JO - J Clin Med VL - 9 IS - 1 N2 - This retrospective observational study assessed the differences between monomicrobial and polymicrobial A. baumannii bacteremia and identified possible independent risk factors for 14-day mortality. There were 379 patients with A. baumannii bacteremia admitted to a tertiary care center in northern Taiwan between August 2008 and July 2015 enrolled for data analysis. Among them, 89 patients (23.5%) had polymicrobial bacteremia and 290 patients (76.5%) had monomicrobial bacteremia. No significant difference in 14-day mortality was observed between patients with monomicrobial and polymicrobial A. baumannii bacteremia (26.9% vs. 29.2%, p = 0.77). Logistic regression controlled for confounders demonstrated that polymicrobial bacteremia was not an independent predictor of mortality, whereas appropriate antimicrobial therapy was independently associated with reduced mortality. Higher 14-day mortality rates were observed in the polymicrobial bacteremic patients with concomitant isolation of Escherichia coli, Pseudomonas aeruginosa, and Enterobacter spp. from the bloodstream. Compared with patients with monomicrobial multidrug-resistant A. baumannii (MDRAb) bacteremia, those with MDRAb concomitant with Gram-negative bacilli bacteremia had a worse outcome. Polymicrobial A. baumannii bacteremia was not associated with a higher 14-day mortality rate than that of monomicrobial A. baumannii bacteremia, although more deaths were observed when certain Gram-negative bacteria were concomitantly isolated. Appropriate antimicrobial therapy remains an important life-saving measure for A. baumannii bacteremic patients. SN - 2077-0383 UR - https://www.unboundmedicine.com/medline/citation/31935954/Is_Polymicrobial_Bacteremia_an_Independent_Risk_Factor_for_Mortality_in_Acinetobacter_baumannii_Bacteremia L2 - http://www.mdpi.com/resolver?pii=jcm9010153 DB - PRIME DP - Unbound Medicine ER -