Ten-Year Changes in Bloodstream Infection With Acinetobacter Baumannii Complex in Intensive Care Units in Eastern China : A Retrospective Cohort Study
Copyright © 2021 Meng, Fu, Zheng, Qin, Yang, Cao, Lu, Zhang, Du, Pang, Li, Guo, Du, Li, Wu and Wang..
Background: There is little evidence on the changing prevalence, microbiological profile, and outcome of nosocomial Acinetobacter baumannii complex (ABC)-caused bloodstream infection (ABCBSI) specified in intensive care units (ICUs) in long-term studies, especially in China. Objective: We aimed to investigate changes in incidence, antibiotic resistance, therapy, and prognosis of ABCBSI in ICUs in eastern China during 2009-2018. Methods: A multicenter retrospective cohort study was conducted, and microbiological and clinical data for patients with ABCBSI acquired in nine adult ICUs in eastern China from 2009 to 2018. Results: A total of 202 cases were enrolled. For the years 2009-2010, 2011-2012, 2013-2014, 2015-2016, and 2017-2018, the incidence of ABCBSI increased significantly, as did the percentage of pan-drug-resistant isolates and resistant rates to most of antimicrobial agents; the percentage of drug-sensitive isolates decreased (all P < 0.05). The frequency of treatment with carbapenems and tigecycline increased, and that of cephalosporins decreased. Compared with those in the first years (2009-2012), ABCBSI patients in the lattermost years (2017-2018) were less often treated with appropriate empirical therapy, more often underwent pneumonia-related ABCBSI and mechanical ventilation support, and had higher 28-day mortality rates. Multivariate Cox regression indicated that increase in the degree of ABC antibiotics resistance, pneumonia-related ABCBSI, and septic shock were risk factors of 28-day mortality and associated with significant lower survival days. Conclusions: The past decade has witnessed a marked increase in the incidence of ABCBSI and in antibiotic resistance, with increasing pneumonia-related infections and worrisome mortality in ICUs in China. Controlling increasing resistance and preventing nosocomial pneumonia may play important roles in combatting these infections.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:8 |
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| Enthalten in: |
Frontiers in medicine - 8(2021) vom: 16., Seite 715213 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Meng, Xiao [VerfasserIn] |
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| Links: |
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| Themen: |
Acinetobacter baumannii complex |
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| Anmerkungen: |
Date Revised 24.08.2021 published: Electronic-eCollection Citation Status PubMed-not-MEDLINE |
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| doi: |
10.3389/fmed.2021.715213 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM329662309 |
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| 520 | |a Copyright © 2021 Meng, Fu, Zheng, Qin, Yang, Cao, Lu, Zhang, Du, Pang, Li, Guo, Du, Li, Wu and Wang. | ||
| 520 | |a Background: There is little evidence on the changing prevalence, microbiological profile, and outcome of nosocomial Acinetobacter baumannii complex (ABC)-caused bloodstream infection (ABCBSI) specified in intensive care units (ICUs) in long-term studies, especially in China. Objective: We aimed to investigate changes in incidence, antibiotic resistance, therapy, and prognosis of ABCBSI in ICUs in eastern China during 2009-2018. Methods: A multicenter retrospective cohort study was conducted, and microbiological and clinical data for patients with ABCBSI acquired in nine adult ICUs in eastern China from 2009 to 2018. Results: A total of 202 cases were enrolled. For the years 2009-2010, 2011-2012, 2013-2014, 2015-2016, and 2017-2018, the incidence of ABCBSI increased significantly, as did the percentage of pan-drug-resistant isolates and resistant rates to most of antimicrobial agents; the percentage of drug-sensitive isolates decreased (all P < 0.05). The frequency of treatment with carbapenems and tigecycline increased, and that of cephalosporins decreased. Compared with those in the first years (2009-2012), ABCBSI patients in the lattermost years (2017-2018) were less often treated with appropriate empirical therapy, more often underwent pneumonia-related ABCBSI and mechanical ventilation support, and had higher 28-day mortality rates. Multivariate Cox regression indicated that increase in the degree of ABC antibiotics resistance, pneumonia-related ABCBSI, and septic shock were risk factors of 28-day mortality and associated with significant lower survival days. Conclusions: The past decade has witnessed a marked increase in the incidence of ABCBSI and in antibiotic resistance, with increasing pneumonia-related infections and worrisome mortality in ICUs in China. Controlling increasing resistance and preventing nosocomial pneumonia may play important roles in combatting these infections | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Acinetobacter baumannii complex | |
| 650 | 4 | |a antibiotic resistance | |
| 650 | 4 | |a bloodstream infection | |
| 650 | 4 | |a eastern China | |
| 650 | 4 | |a prognosis | |
| 700 | 1 | |a Fu, Jintao |e verfasserin |4 aut | |
| 700 | 1 | |a Zheng, Yue |e verfasserin |4 aut | |
| 700 | 1 | |a Qin, Weidong |e verfasserin |4 aut | |
| 700 | 1 | |a Yang, Hongna |e verfasserin |4 aut | |
| 700 | 1 | |a Cao, Dongming |e verfasserin |4 aut | |
| 700 | 1 | |a Lu, Haining |e verfasserin |4 aut | |
| 700 | 1 | |a Zhang, Lu |e verfasserin |4 aut | |
| 700 | 1 | |a Du, Zhiguo |e verfasserin |4 aut | |
| 700 | 1 | |a Pang, Jiaojiao |e verfasserin |4 aut | |
| 700 | 1 | |a Li, Wei |e verfasserin |4 aut | |
| 700 | 1 | |a Guo, Haipeng |e verfasserin |4 aut | |
| 700 | 1 | |a Du, Juan |e verfasserin |4 aut | |
| 700 | 1 | |a Li, Chen |e verfasserin |4 aut | |
| 700 | 1 | |a Wu, Dawei |e verfasserin |4 aut | |
| 700 | 1 | |a Wang, Hao |e verfasserin |4 aut | |
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