- Comorbidities, septic shock, and inadequate source control increase 30-day mortality risk in hospitalized patients with multidrug-resistant Acinetobacter baumannii (MDR-AB) bloodstream infections (BSIs).
Why this matters
- While there is a dearth of data explaining high mortality rates among MDR-AB patients, adequate, early source control and avoidance of aerosolized colistin may help improve outcomes among patients with concomitant pneumonia.
- Among 281 MDR-AB BSIs, 34.8% (98), 65.2% (183) were classified as primary, secondary bacteremia, respectively.
- 62.9% (177) were associated with septic shock.
- 98.6% of strains were extensively drug-resistant.
- 14-, 30-day mortality observed in 61.2% (172) and 73.6% (207) of patients, respectively.
- Multivariate factors: previous surgery (OR, 33.9; P<.001 continuous renal replacement therapy no source control pneumonia associated with higher septic shock risk.>
- 14-day mortality risk factors: septic shock (HR, 10.79; P=.04), Charlson Comorbidity score >3 (HR, 1.44; P=.02).
- 30-day mortality was 82.5% in presence of septic shock (P<.001>
- Highest 30-day mortality rates observed in patients treated with 3-drug combination (78.3%), carbapenem- (73.1%), or colistin-containing (70.9%).
- Prospective, observational, multicenter Italian study of 281 patients with MDR-AB BSI.
- Funding: None.
- Heterogeneous MDR-AB incidence across centers.
- Underlying resistance mechanisms not captured.