|Title:||Acinetobacter baumannii and Acinetobacter genospecies 13tu and 3 bacteraemia: Comparison of clinical features, prognostic factors and outcomes||Authors:||Lee Y.-C.
|Issue Date:||2011||Journal Volume:||66||Journal Issue:||8||Start page/Pages:||1839-1846||Source:||Journal of Antimicrobial Chemotherapy||Abstract:||
Objectives: To investigate the clinical impact of different genospecies of the Acinetobacter calcoaceticus-Acinetobacter baumannii complex (ACB complex; A. baumannii, Acinetobacter gen. sp. 13TU and Acinetobacter gen. sp. 3) on the severity of bacteraemia. Methods: We retrospectively compared the clinical features and outcomes of patients with bacteraemia caused by A. baumannii, Acinetobacter gen. sp. 13TU or Acinetobacter gen. sp. 3. The genospecies were identified using oligonucleotide array sequence analysis (interspacer sequence), and the clonality of Acinetobacter gen. sp. 13TU and 3 isolates was determined by PFGE analysis. Results: A total of 215 patients with bacteraemia due to ACB complex were evaluated. Among them, 117 (54.4%) had A. baumannii bacteraemia, 77 (35.8%) had Acinetobacter gen. sp. 13TU bacteraemia and 21 (9.8%) had Acinetobacter gen. sp. 3 bacteraemia. A. baumannii bacteraemia was associated with a higher 14 day mortality rate (P<0.001), a higher 30 day mortality rate (P<0.001) and a higher in-hospital mortality rate than bacteraemia due to Acinetobacter gen. sp. 13TU or Acinetobacter gen. sp. 3. Independent prognostic factors for the 30 day mortality included the Charlson co-morbidity index (P<0.001) and Pitt bacteraemia score (P<0.001). Bloodstream infection caused by a multidrug-resistant A. baumannii isolate appeared to be associated with a poor outcome (P=0.069). There was no clonal spread of Acinetobacter gen. sp. 13TU or Acinetobacter gen. sp. 3 during the study period. Conclusions: Bacteraemia due to multidrug-resistant strains but not A. baumannii per se appears to be associated with poor outcome. ? The Author 2011. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved.
|ISSN:||0305-7453||DOI:||10.1093/jac/dkr200||metadata.dc.subject.other:||amikacin; carbapenem; cefepime; ceftazidime; ciprofloxacin; colistin; doripenem; gentamicin; imipenem; levofloxacin; meropenem; piperacillin plus tazobactam; sultamicillin; tigecycline; timentin; abdominal infection; Acinetobacter baumannii; Acinetobacter calcoaceticus; acquired immune deficiency syndrome; adult; antibiotic sensitivity; antibiotic therapy; article; bacteremia; bacterial strain; central venous catheter; cerebrovascular accident; chronic lung disease; clonal variation; comorbidity; congestive heart failure; connective tissue disease; dementia; diabetes mellitus; disease severity; female; genotype; heart infarction; hemiplegia; human; kidney disease; length of stay; leukemia; liver disease; lymphoma; major clinical study; male; metastasis; mortality; peptic ulcer; peripheral occlusive artery disease; pneumonia; prognosis; retrospective study; sequence analysis; urinary tract infection; wound; Acinetobacter; Acinetobacter Infections; Adult; Aged; Anti-Bacterial Agents; Bacteremia; DNA, Bacterial; Drug Resistance, Multiple, Bacterial; Electrophoresis, Gel, Pulsed-Field; Female; Genotype; Humans; Male; Microarray Analysis; Middle Aged; Molecular Typing; Prognosis; Treatment Outcome
|Appears in Collections:||醫學系|
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