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Predictive value of the serum bactericidal test for mortality in patients infected with multidrug-resistant Acinetobacter baumannii
Journal
Journal of Infection
Journal Volume
55
Journal Issue
2
Pages
149-157
Date Issued
2007
Author(s)
Abstract
Objective: Strains of Acinetobacter baumannii resistant to all available antibiotics except polymyxin B have circulated in Taiwan since 1998 and have caused a variety of nosocomial infections. There are no standard tests to measure outcome in patients infected with these strains. Our aim was to determine whether a serum bactericidal test (SBT) could be used for this purpose. Methods: This SBT was performed in 57 infected patients. Results: Among the 35 patients who survived and 22 patients who died, peak SBT titer negatively correlated with mortality rate (correlation coefficient -0.43). The survival rate in patients with a peak SBT titer ≧1:16, ≧1:8, and ≦1:4 was 100%, 87.5%, and 42.4%, respectively (p = 0.001). Mortality was found to be closely related to illness severity and the presence of multiple organ failure. In subgroup analysis, the power of SBT to predict mortality was significant for patients without multiple organ failure (p = 0.004), and also patients without disease defined as rapidly fatal by McCabe classification (p = 0.044). Conclusion: In a region with few therapeutic options for multi-drug resistant Acinetobacter baumannii (MDRAB), such as in Taiwan, SBT could be used as a prognosis indicator and indicator of the need to modify treatment in patients infected with MDRAB. ? 2007 The British Infection Society.
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Other Subjects
amikacin; aminoglycoside; aztreonam; carbapenem; cefepime; ceftazidime; cephalosporin; ciprofloxacin; gentamicin; imipenem; penicillin G; piperacillin plus tazobactam; sulbactam; sultamicillin; Acinetobacter baumannii; adolescent; adult; aged; antibiotic sensitivity; article; bacterial infection; combination chemotherapy; controlled study; disease severity; female; human; major clinical study; male; minimum inhibitory concentration; monotherapy; mortality; multidrug resistance; multiple organ failure; nonhuman; prediction; preschool child; prognosis; serum bactericidal activity; survival rate; Taiwan; Acinetobacter baumannii; Acinetobacter Infections; Adolescent; Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents; Child; Drug Resistance, Multiple, Bacterial; Female; Humans; Male; Middle Aged; Multiple Organ Failure; Predictive Value of Tests; Prognosis; Serum Bactericidal Test; Severity of Illness Index; Taiwan
Type
journal article