Risk factors for carbapenem-resistant Acinetobacter baumannii (CRAB) bloodstream infections and related mortality in critically ill patients with CRAB colonization
Abstract Background Among MDR bacteria, carbapenem-resistant Acinetobacter baumannii (CRAB) is a major concern due to the limited therapeutic options. During the COVID-19 pandemic, a worrying increase in the spread of CRAB infections was reported. Objectives The study assessed the risk factors for C...
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| Veröffentlicht in: | JAC-antimicrobial resistance 2023-08, Vol.5 (4), p.dlad096-dlad096 |
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| creator | Cogliati Dezza, Francesco Covino, Sara Petrucci, Flavia Sacco, Federica Viscido, Agnese Gavaruzzi, Francesca Ceccarelli, Giancarlo Raponi, Gianmarco Borrazzo, Cristian Alessandri, Francesco Mastroianni, Claudio Maria Venditti, Mario Oliva, Alessandra |
| description | Abstract
Background
Among MDR bacteria, carbapenem-resistant Acinetobacter baumannii (CRAB) is a major concern due to the limited therapeutic options. During the COVID-19 pandemic, a worrying increase in the spread of CRAB infections was reported.
Objectives
The study assessed the risk factors for CRAB bloodstream infection (BSI) in patients admitted to the ICU with CRAB colonization, and the related mortality risk factors.
Methods
We conducted a single-centre, observational, prospective study; all consecutive patients with CRAB colonization admitted to the ICU of a tertiary hospital in Rome from January 2021 to September 2022 were included in the study. Univariate and multivariate analyses were performed to investigate BSI and mortality risk factors.
Results
Overall, 129 patients were included in the study; 57 (44%) out of these developed BSI. In our study population, at the multivariable analysis the Charlson comorbidity index (CCI) (P = 0.026), COVID-19 (P |
| doi_str_mv | 10.1093/jacamr/dlad096 |
| format | Article |
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Background
Among MDR bacteria, carbapenem-resistant Acinetobacter baumannii (CRAB) is a major concern due to the limited therapeutic options. During the COVID-19 pandemic, a worrying increase in the spread of CRAB infections was reported.
Objectives
The study assessed the risk factors for CRAB bloodstream infection (BSI) in patients admitted to the ICU with CRAB colonization, and the related mortality risk factors.
Methods
We conducted a single-centre, observational, prospective study; all consecutive patients with CRAB colonization admitted to the ICU of a tertiary hospital in Rome from January 2021 to September 2022 were included in the study. Univariate and multivariate analyses were performed to investigate BSI and mortality risk factors.
Results
Overall, 129 patients were included in the study; 57 (44%) out of these developed BSI. In our study population, at the multivariable analysis the Charlson comorbidity index (CCI) (P = 0.026), COVID-19 (P < 0.001), multisite colonization (P = 0.016) and the need for mechanical ventilation (P = 0.024) were risk factors independently associated with BSI development. Furthermore, age (P = 0.026), CCI (P < 0.001), septic shock (P = 0.001) and Pitt score (P < 0.001) were independently associated with mortality in the BSI patients. Instead, early appropriate therapy (P = 0.002) and clinical improvement within 72 h (P = 0.011) were shown to be protective factors.
Conclusions
In critically ill patients colonized by CRAB, higher CCI, multisite colonization and the need for mechanical ventilation were identified as risk factors for BSI onset. These predictors could be useful to identify patients at highest risk of BSI.</description><identifier>ISSN: 2632-1823</identifier><identifier>EISSN: 2632-1823</identifier><identifier>DOI: 10.1093/jacamr/dlad096</identifier><identifier>PMID: 37577156</identifier><language>eng</language><publisher>US: Oxford University Press</publisher><subject>Original</subject><ispartof>JAC-antimicrobial resistance, 2023-08, Vol.5 (4), p.dlad096-dlad096</ispartof><rights>The Author(s) 2023. Published by Oxford University Press on behalf of British Society for Antimicrobial Chemotherapy. 2023</rights><rights>The Author(s) 2023. Published by Oxford University Press on behalf of British Society for Antimicrobial Chemotherapy.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c425t-2b9e8fddd7429b81baf80f2063125796060b31d2b96d530d11266138642931163</citedby><cites>FETCH-LOGICAL-c425t-2b9e8fddd7429b81baf80f2063125796060b31d2b96d530d11266138642931163</cites><orcidid>0000-0001-5921-3180 ; 0000-0002-2346-898X ; 0000-0003-0832-7975</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10412853/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10412853/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,1603,27923,27924,53790,53792</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37577156$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Cogliati Dezza, Francesco</creatorcontrib><creatorcontrib>Covino, Sara</creatorcontrib><creatorcontrib>Petrucci, Flavia</creatorcontrib><creatorcontrib>Sacco, Federica</creatorcontrib><creatorcontrib>Viscido, Agnese</creatorcontrib><creatorcontrib>Gavaruzzi, Francesca</creatorcontrib><creatorcontrib>Ceccarelli, Giancarlo</creatorcontrib><creatorcontrib>Raponi, Gianmarco</creatorcontrib><creatorcontrib>Borrazzo, Cristian</creatorcontrib><creatorcontrib>Alessandri, Francesco</creatorcontrib><creatorcontrib>Mastroianni, Claudio Maria</creatorcontrib><creatorcontrib>Venditti, Mario</creatorcontrib><creatorcontrib>Oliva, Alessandra</creatorcontrib><title>Risk factors for carbapenem-resistant Acinetobacter baumannii (CRAB) bloodstream infections and related mortality in critically ill patients with CRAB colonization</title><title>JAC-antimicrobial resistance</title><addtitle>JAC Antimicrob Resist</addtitle><description>Abstract
Background
Among MDR bacteria, carbapenem-resistant Acinetobacter baumannii (CRAB) is a major concern due to the limited therapeutic options. During the COVID-19 pandemic, a worrying increase in the spread of CRAB infections was reported.
Objectives
The study assessed the risk factors for CRAB bloodstream infection (BSI) in patients admitted to the ICU with CRAB colonization, and the related mortality risk factors.
Methods
We conducted a single-centre, observational, prospective study; all consecutive patients with CRAB colonization admitted to the ICU of a tertiary hospital in Rome from January 2021 to September 2022 were included in the study. Univariate and multivariate analyses were performed to investigate BSI and mortality risk factors.
Results
Overall, 129 patients were included in the study; 57 (44%) out of these developed BSI. In our study population, at the multivariable analysis the Charlson comorbidity index (CCI) (P = 0.026), COVID-19 (P < 0.001), multisite colonization (P = 0.016) and the need for mechanical ventilation (P = 0.024) were risk factors independently associated with BSI development. Furthermore, age (P = 0.026), CCI (P < 0.001), septic shock (P = 0.001) and Pitt score (P < 0.001) were independently associated with mortality in the BSI patients. Instead, early appropriate therapy (P = 0.002) and clinical improvement within 72 h (P = 0.011) were shown to be protective factors.
Conclusions
In critically ill patients colonized by CRAB, higher CCI, multisite colonization and the need for mechanical ventilation were identified as risk factors for BSI onset. These predictors could be useful to identify patients at highest risk of BSI.</description><subject>Original</subject><issn>2632-1823</issn><issn>2632-1823</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>TOX</sourceid><recordid>eNqFkU1rFTEUhgdRbKndupQs28W0-ZhJZlZyvagVCkLRdTj5GJuaScYko9S_4x81l3tb6srVySFPnrzwNs1rgi8IHtnlHWiY06XxYPDInzXHlDPakoGy50_OR81pzncYY9pj0Qn6sjlioheC9Py4-XPj8nc0gS4xZTTFhDQkBYsNdm6TzS4XCAVttAu2RFU5m5CCdYYQnENn25vNu3OkfIwml2RhRi5MVhcXQ0YQDErWQ7EGzTEV8K7cVwDp5IrT4H3dvEcLFGdDyeiXK7dop0Q6-hjcb9iJXjUvJvDZnh7mSfP1w_sv26v2-vPHT9vNdas72peWqtEOkzFGdHRUA1EwDXiimDNCezFyzLFixFSMm55hQwjlnLCBV5wRwtlJ83bvXVY1W6NrpAReLsnNkO5lBCf_vQnuVn6LPyXBHaFDz6rh7GBI8cdqc5Gzy9p6D8HGNcsKYUFE39GKXuxRnWLOyU6P_xAsd-3Kfbvy0G598OZpukf8ocsKnO-BuC7_k_0Fxta0Dg</recordid><startdate>20230801</startdate><enddate>20230801</enddate><creator>Cogliati Dezza, Francesco</creator><creator>Covino, Sara</creator><creator>Petrucci, Flavia</creator><creator>Sacco, Federica</creator><creator>Viscido, Agnese</creator><creator>Gavaruzzi, Francesca</creator><creator>Ceccarelli, Giancarlo</creator><creator>Raponi, Gianmarco</creator><creator>Borrazzo, Cristian</creator><creator>Alessandri, Francesco</creator><creator>Mastroianni, Claudio Maria</creator><creator>Venditti, Mario</creator><creator>Oliva, Alessandra</creator><general>Oxford University Press</general><scope>TOX</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0001-5921-3180</orcidid><orcidid>https://orcid.org/0000-0002-2346-898X</orcidid><orcidid>https://orcid.org/0000-0003-0832-7975</orcidid></search><sort><creationdate>20230801</creationdate><title>Risk factors for carbapenem-resistant Acinetobacter baumannii (CRAB) bloodstream infections and related mortality in critically ill patients with CRAB colonization</title><author>Cogliati Dezza, Francesco ; Covino, Sara ; Petrucci, Flavia ; Sacco, Federica ; Viscido, Agnese ; Gavaruzzi, Francesca ; Ceccarelli, Giancarlo ; Raponi, Gianmarco ; Borrazzo, Cristian ; Alessandri, Francesco ; Mastroianni, Claudio Maria ; Venditti, Mario ; Oliva, Alessandra</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c425t-2b9e8fddd7429b81baf80f2063125796060b31d2b96d530d11266138642931163</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Original</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Cogliati Dezza, Francesco</creatorcontrib><creatorcontrib>Covino, Sara</creatorcontrib><creatorcontrib>Petrucci, Flavia</creatorcontrib><creatorcontrib>Sacco, Federica</creatorcontrib><creatorcontrib>Viscido, Agnese</creatorcontrib><creatorcontrib>Gavaruzzi, Francesca</creatorcontrib><creatorcontrib>Ceccarelli, Giancarlo</creatorcontrib><creatorcontrib>Raponi, Gianmarco</creatorcontrib><creatorcontrib>Borrazzo, Cristian</creatorcontrib><creatorcontrib>Alessandri, Francesco</creatorcontrib><creatorcontrib>Mastroianni, Claudio Maria</creatorcontrib><creatorcontrib>Venditti, Mario</creatorcontrib><creatorcontrib>Oliva, Alessandra</creatorcontrib><collection>Oxford Journals Open Access Collection</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>JAC-antimicrobial resistance</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Cogliati Dezza, Francesco</au><au>Covino, Sara</au><au>Petrucci, Flavia</au><au>Sacco, Federica</au><au>Viscido, Agnese</au><au>Gavaruzzi, Francesca</au><au>Ceccarelli, Giancarlo</au><au>Raponi, Gianmarco</au><au>Borrazzo, Cristian</au><au>Alessandri, Francesco</au><au>Mastroianni, Claudio Maria</au><au>Venditti, Mario</au><au>Oliva, Alessandra</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Risk factors for carbapenem-resistant Acinetobacter baumannii (CRAB) bloodstream infections and related mortality in critically ill patients with CRAB colonization</atitle><jtitle>JAC-antimicrobial resistance</jtitle><addtitle>JAC Antimicrob Resist</addtitle><date>2023-08-01</date><risdate>2023</risdate><volume>5</volume><issue>4</issue><spage>dlad096</spage><epage>dlad096</epage><pages>dlad096-dlad096</pages><issn>2632-1823</issn><eissn>2632-1823</eissn><abstract>Abstract
Background
Among MDR bacteria, carbapenem-resistant Acinetobacter baumannii (CRAB) is a major concern due to the limited therapeutic options. During the COVID-19 pandemic, a worrying increase in the spread of CRAB infections was reported.
Objectives
The study assessed the risk factors for CRAB bloodstream infection (BSI) in patients admitted to the ICU with CRAB colonization, and the related mortality risk factors.
Methods
We conducted a single-centre, observational, prospective study; all consecutive patients with CRAB colonization admitted to the ICU of a tertiary hospital in Rome from January 2021 to September 2022 were included in the study. Univariate and multivariate analyses were performed to investigate BSI and mortality risk factors.
Results
Overall, 129 patients were included in the study; 57 (44%) out of these developed BSI. In our study population, at the multivariable analysis the Charlson comorbidity index (CCI) (P = 0.026), COVID-19 (P < 0.001), multisite colonization (P = 0.016) and the need for mechanical ventilation (P = 0.024) were risk factors independently associated with BSI development. Furthermore, age (P = 0.026), CCI (P < 0.001), septic shock (P = 0.001) and Pitt score (P < 0.001) were independently associated with mortality in the BSI patients. Instead, early appropriate therapy (P = 0.002) and clinical improvement within 72 h (P = 0.011) were shown to be protective factors.
Conclusions
In critically ill patients colonized by CRAB, higher CCI, multisite colonization and the need for mechanical ventilation were identified as risk factors for BSI onset. These predictors could be useful to identify patients at highest risk of BSI.</abstract><cop>US</cop><pub>Oxford University Press</pub><pmid>37577156</pmid><doi>10.1093/jacamr/dlad096</doi><orcidid>https://orcid.org/0000-0001-5921-3180</orcidid><orcidid>https://orcid.org/0000-0002-2346-898X</orcidid><orcidid>https://orcid.org/0000-0003-0832-7975</orcidid><oa>free_for_read</oa></addata></record> |
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| source | DOAJ Directory of Open Access Journals; Oxford Journals Open Access Collection; EZB-FREE-00999 freely available EZB journals; PubMed Central |
| subjects | Original |
| title | Risk factors for carbapenem-resistant Acinetobacter baumannii (CRAB) bloodstream infections and related mortality in critically ill patients with CRAB colonization |
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