Risk factors for 30-day mortality in patients with carbapenem-resistant Acinetobacter baumannii during an outbreak in an intensive care unit
This study assessed risk factors for 30-day mortality in 66 patients with carbapenem-resistant Acinetobacter baumannii (CRAB) infection or colonization during an outbreak in an intensive-care unit. Clinical and demographic characteristics were evaluated. The overall 30-day mortality was 47·0%. In th...
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| Veröffentlicht in: | Epidemiology and infection 2011-03, Vol.139 (3), p.411-418 |
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| container_title | Epidemiology and infection |
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| creator | PRATES, C. G. MARTINS, A. F. SUPERTI, S. V. LOPES, F. S. RAMOS, F. CANTARELLI, V. V. ZAVASCKI, A. P. |
| description | This study assessed risk factors for 30-day mortality in 66 patients with carbapenem-resistant Acinetobacter baumannii (CRAB) infection or colonization during an outbreak in an intensive-care unit. Clinical and demographic characteristics were evaluated. The overall 30-day mortality was 47·0%. In the multivariate Cox regression model, septic shock [adjusted hazard ratio (aHR) 5·01, 95% confidence interval (CI) 2·32–10·01] and APACHE II score at onset of infection (aHR 1·11, 95% CI 1·04–1·18) were significantly associated with 30-day mortality. Administration of appropriate therapy was a protective factor, but it was not statistically significant (aHR 0·48, 95% CI 0·21–1·12). A sample of isolates tested (n=27) carried the blaOXA-23 gene. Severity of baseline condition and severity of infection presentation were major risk factors for mortality during the outbreak. Patients who received appropriate therapy tended to have lower mortality rates, although therapy was started late and dosage was suboptimal in most cases. |
| doi_str_mv | 10.1017/S0950268810001238 |
| format | Article |
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G. ; MARTINS, A. F. ; SUPERTI, S. V. ; LOPES, F. S. ; RAMOS, F. ; CANTARELLI, V. V. ; ZAVASCKI, A. P.</creator><creatorcontrib>PRATES, C. G. ; MARTINS, A. F. ; SUPERTI, S. V. ; LOPES, F. S. ; RAMOS, F. ; CANTARELLI, V. V. ; ZAVASCKI, A. P.</creatorcontrib><description>This study assessed risk factors for 30-day mortality in 66 patients with carbapenem-resistant Acinetobacter baumannii (CRAB) infection or colonization during an outbreak in an intensive-care unit. Clinical and demographic characteristics were evaluated. The overall 30-day mortality was 47·0%. In the multivariate Cox regression model, septic shock [adjusted hazard ratio (aHR) 5·01, 95% confidence interval (CI) 2·32–10·01] and APACHE II score at onset of infection (aHR 1·11, 95% CI 1·04–1·18) were significantly associated with 30-day mortality. Administration of appropriate therapy was a protective factor, but it was not statistically significant (aHR 0·48, 95% CI 0·21–1·12). A sample of isolates tested (n=27) carried the blaOXA-23 gene. Severity of baseline condition and severity of infection presentation were major risk factors for mortality during the outbreak. Patients who received appropriate therapy tended to have lower mortality rates, although therapy was started late and dosage was suboptimal in most cases.</description><identifier>ISSN: 0950-2688</identifier><identifier>EISSN: 1469-4409</identifier><identifier>DOI: 10.1017/S0950268810001238</identifier><identifier>PMID: 20513254</identifier><identifier>CODEN: EPINEU</identifier><language>eng</language><publisher>Cambridge, UK: Cambridge University Press</publisher><subject>Acinetobacter ; Acinetobacter baumannii ; Acinetobacter baumannii - drug effects ; Acinetobacter baumannii - isolation & purification ; Acinetobacter Infections - complications ; Acinetobacter Infections - epidemiology ; Acinetobacter Infections - mortality ; Acinetobacter Infections - pathology ; Aged ; Aged, 80 and over ; Anti-Bacterial Agents - therapeutic use ; Antimicrobial agents ; Antimicrobials ; APACHE ; Bacterial infections ; Bacterial infections/HAI ; Bacteriology ; beta-Lactam Resistance ; Biological and medical sciences ; Blood pressure ; Carbapenems - pharmacology ; Cross Infection - epidemiology ; Cross Infection - mortality ; Cross Infection - pathology ; Decapoda ; Disease Outbreaks ; Epidemics ; Female ; Fundamental and applied biological sciences. Psychology ; Hospital units ; Hospitals ; Humans ; Infections ; Intensive Care Units ; Male ; Microbiology ; Miscellaneous ; Mortality ; Patients ; Polymyxins ; Predisposing factors ; Risk Factors ; Sepsis ; Septic shock ; Shock, Septic - mortality ; Shock, Septic - pathology ; Ventilators</subject><ispartof>Epidemiology and infection, 2011-03, Vol.139 (3), p.411-418</ispartof><rights>Copyright © Cambridge University Press 2010</rights><rights>2011 Cambridge University Press</rights><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c455t-e42059e0da82bc6510e6049c0bdecf0f433307b82faa23b85e3d82c7f6c2ae323</citedby><cites>FETCH-LOGICAL-c455t-e42059e0da82bc6510e6049c0bdecf0f433307b82faa23b85e3d82c7f6c2ae323</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.jstor.org/stable/pdf/27918213$$EPDF$$P50$$Gjstor$$H</linktopdf><linktohtml>$$Uhttps://www.jstor.org/stable/27918213$$EHTML$$P50$$Gjstor$$H</linktohtml><link.rule.ids>314,780,784,803,27924,27925,58017,58250</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=23951785$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20513254$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>PRATES, C. G.</creatorcontrib><creatorcontrib>MARTINS, A. F.</creatorcontrib><creatorcontrib>SUPERTI, S. V.</creatorcontrib><creatorcontrib>LOPES, F. S.</creatorcontrib><creatorcontrib>RAMOS, F.</creatorcontrib><creatorcontrib>CANTARELLI, V. V.</creatorcontrib><creatorcontrib>ZAVASCKI, A. P.</creatorcontrib><title>Risk factors for 30-day mortality in patients with carbapenem-resistant Acinetobacter baumannii during an outbreak in an intensive care unit</title><title>Epidemiology and infection</title><addtitle>Epidemiol Infect</addtitle><description>This study assessed risk factors for 30-day mortality in 66 patients with carbapenem-resistant Acinetobacter baumannii (CRAB) infection or colonization during an outbreak in an intensive-care unit. Clinical and demographic characteristics were evaluated. The overall 30-day mortality was 47·0%. In the multivariate Cox regression model, septic shock [adjusted hazard ratio (aHR) 5·01, 95% confidence interval (CI) 2·32–10·01] and APACHE II score at onset of infection (aHR 1·11, 95% CI 1·04–1·18) were significantly associated with 30-day mortality. Administration of appropriate therapy was a protective factor, but it was not statistically significant (aHR 0·48, 95% CI 0·21–1·12). A sample of isolates tested (n=27) carried the blaOXA-23 gene. Severity of baseline condition and severity of infection presentation were major risk factors for mortality during the outbreak. Patients who received appropriate therapy tended to have lower mortality rates, although therapy was started late and dosage was suboptimal in most cases.</description><subject>Acinetobacter</subject><subject>Acinetobacter baumannii</subject><subject>Acinetobacter baumannii - drug effects</subject><subject>Acinetobacter baumannii - isolation & purification</subject><subject>Acinetobacter Infections - complications</subject><subject>Acinetobacter Infections - epidemiology</subject><subject>Acinetobacter Infections - mortality</subject><subject>Acinetobacter Infections - pathology</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Anti-Bacterial Agents - therapeutic use</subject><subject>Antimicrobial agents</subject><subject>Antimicrobials</subject><subject>APACHE</subject><subject>Bacterial infections</subject><subject>Bacterial infections/HAI</subject><subject>Bacteriology</subject><subject>beta-Lactam Resistance</subject><subject>Biological and medical sciences</subject><subject>Blood pressure</subject><subject>Carbapenems - pharmacology</subject><subject>Cross Infection - epidemiology</subject><subject>Cross Infection - mortality</subject><subject>Cross Infection - pathology</subject><subject>Decapoda</subject><subject>Disease Outbreaks</subject><subject>Epidemics</subject><subject>Female</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>Hospital units</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Infections</subject><subject>Intensive Care Units</subject><subject>Male</subject><subject>Microbiology</subject><subject>Miscellaneous</subject><subject>Mortality</subject><subject>Patients</subject><subject>Polymyxins</subject><subject>Predisposing factors</subject><subject>Risk Factors</subject><subject>Sepsis</subject><subject>Septic shock</subject><subject>Shock, Septic - mortality</subject><subject>Shock, Septic - pathology</subject><subject>Ventilators</subject><issn>0950-2688</issn><issn>1469-4409</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNqNkVuLFDEQhRtR3HH1B_igBEF8as21k35cFm-wIHh5birp6jWz3ekxSa_Mf_BHm2ZGBxTBp6I4Xx1OcarqMaMvGWX61SfaKsobYxillHFh7lQbJpu2lpK2d6vNKterflY9SGlboJYbfb8641QxwZXcVD8--nRDBnB5jokMcySC1j3syTTHDKPPe-ID2UH2GHIi333-ShxECzsMONURk08ZQiYXzgfMsy1OGImFZYIQvCf9En24JhDIvGQbEW5Ww7L6kDEkf4urH5Il-PywujfAmPDRcZ5XX968_nz5rr768Pb95cVV7aRSuUZZ8rdIezDcukYxig2VraO2RzfQQQohqLaGDwBcWKNQ9IY7PTSOAwouzqsXB99dnL8tmHI3-eRwHCHgvKTOqEabljb_QUojmGRMF_LZH-R2XmIobxRIa6UNMwViB8jFOaWIQ7eLfoK47xjt1kq7vyotN0-PxoudsP998avDAjw_ApAcjEOE4Hw6caJVTBtVuCcHbptK2Sddt8xwJooujuFgstH313h64d_xfgKwp8LE</recordid><startdate>20110301</startdate><enddate>20110301</enddate><creator>PRATES, C. 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P.</creator><general>Cambridge University Press</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QL</scope><scope>7RV</scope><scope>7T2</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88A</scope><scope>88E</scope><scope>8C1</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>AN0</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>7U1</scope><scope>7U2</scope></search><sort><creationdate>20110301</creationdate><title>Risk factors for 30-day mortality in patients with carbapenem-resistant Acinetobacter baumannii during an outbreak in an intensive care unit</title><author>PRATES, C. G. ; MARTINS, A. F. ; SUPERTI, S. V. ; LOPES, F. S. ; RAMOS, F. ; CANTARELLI, V. V. ; ZAVASCKI, A. 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Psychology</topic><topic>Hospital units</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Infections</topic><topic>Intensive Care Units</topic><topic>Male</topic><topic>Microbiology</topic><topic>Miscellaneous</topic><topic>Mortality</topic><topic>Patients</topic><topic>Polymyxins</topic><topic>Predisposing factors</topic><topic>Risk Factors</topic><topic>Sepsis</topic><topic>Septic shock</topic><topic>Shock, Septic - mortality</topic><topic>Shock, Septic - pathology</topic><topic>Ventilators</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>PRATES, C. G.</creatorcontrib><creatorcontrib>MARTINS, A. F.</creatorcontrib><creatorcontrib>SUPERTI, S. V.</creatorcontrib><creatorcontrib>LOPES, F. S.</creatorcontrib><creatorcontrib>RAMOS, F.</creatorcontrib><creatorcontrib>CANTARELLI, V. V.</creatorcontrib><creatorcontrib>ZAVASCKI, A. 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G.</au><au>MARTINS, A. F.</au><au>SUPERTI, S. V.</au><au>LOPES, F. S.</au><au>RAMOS, F.</au><au>CANTARELLI, V. V.</au><au>ZAVASCKI, A. P.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Risk factors for 30-day mortality in patients with carbapenem-resistant Acinetobacter baumannii during an outbreak in an intensive care unit</atitle><jtitle>Epidemiology and infection</jtitle><addtitle>Epidemiol Infect</addtitle><date>2011-03-01</date><risdate>2011</risdate><volume>139</volume><issue>3</issue><spage>411</spage><epage>418</epage><pages>411-418</pages><issn>0950-2688</issn><eissn>1469-4409</eissn><coden>EPINEU</coden><abstract>This study assessed risk factors for 30-day mortality in 66 patients with carbapenem-resistant Acinetobacter baumannii (CRAB) infection or colonization during an outbreak in an intensive-care unit. Clinical and demographic characteristics were evaluated. The overall 30-day mortality was 47·0%. In the multivariate Cox regression model, septic shock [adjusted hazard ratio (aHR) 5·01, 95% confidence interval (CI) 2·32–10·01] and APACHE II score at onset of infection (aHR 1·11, 95% CI 1·04–1·18) were significantly associated with 30-day mortality. Administration of appropriate therapy was a protective factor, but it was not statistically significant (aHR 0·48, 95% CI 0·21–1·12). A sample of isolates tested (n=27) carried the blaOXA-23 gene. Severity of baseline condition and severity of infection presentation were major risk factors for mortality during the outbreak. Patients who received appropriate therapy tended to have lower mortality rates, although therapy was started late and dosage was suboptimal in most cases.</abstract><cop>Cambridge, UK</cop><pub>Cambridge University Press</pub><pmid>20513254</pmid><doi>10.1017/S0950268810001238</doi><tpages>8</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0950-2688 |
| ispartof | Epidemiology and infection, 2011-03, Vol.139 (3), p.411-418 |
| issn | 0950-2688 1469-4409 |
| language | eng |
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| source | MEDLINE; PubMed Central; JSTOR |
| subjects | Acinetobacter Acinetobacter baumannii Acinetobacter baumannii - drug effects Acinetobacter baumannii - isolation & purification Acinetobacter Infections - complications Acinetobacter Infections - epidemiology Acinetobacter Infections - mortality Acinetobacter Infections - pathology Aged Aged, 80 and over Anti-Bacterial Agents - therapeutic use Antimicrobial agents Antimicrobials APACHE Bacterial infections Bacterial infections/HAI Bacteriology beta-Lactam Resistance Biological and medical sciences Blood pressure Carbapenems - pharmacology Cross Infection - epidemiology Cross Infection - mortality Cross Infection - pathology Decapoda Disease Outbreaks Epidemics Female Fundamental and applied biological sciences. Psychology Hospital units Hospitals Humans Infections Intensive Care Units Male Microbiology Miscellaneous Mortality Patients Polymyxins Predisposing factors Risk Factors Sepsis Septic shock Shock, Septic - mortality Shock, Septic - pathology Ventilators |
| title | Risk factors for 30-day mortality in patients with carbapenem-resistant Acinetobacter baumannii during an outbreak in an intensive care unit |
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