Please use this identifier to cite or link to this item:
|Title:||A multicenter case-case control study for risk factors and outcomes of extensively drug-resistant acinetobacter baumannii bacteremia|
|Citation:||Ng, T.M., Teng, C.B., Lye, D.C., Apisarnthanarak, A. (2014-01). A multicenter case-case control study for risk factors and outcomes of extensively drug-resistant acinetobacter baumannii bacteremia. Infection Control and Hospital Epidemiology 35 (1) : 49-55. ScholarBank@NUS Repository. https://doi.org/10.1086/674387|
|Abstract:||objective. Extensively drug resistant (XDR) Acinetobacter baumannii infections are increasing. Knowledge of risk factors can help to prevent these infections. methods. We designed a 1: 1: 1 case-case-control study to identify risk factors for XDR A. baumannii bacteremia in Singapore and Thailand. Case group 1 was defined as having infection due to XDR A. baumannii, and case group 2 was defined as having infection due to non-XDR A. baumannii. The control group comprised patients with blood cultures obtained to determine possible infection. results. There were 93 patients in each group. Pitt bacteremia score (adjusted odds ratio [aOR], 2.570 [95% confidence interval (CI), 1.528-4.322]), central venous catheters (CVCs; aOR, 12.644 [95% CI, 2.143-74.620]), use of carbapenems (aOR, 54.391 [95% CI, 3.869- 764.674]), and piperacillin-tazobactam (aOR, 55.035 [95% CI, 4.803-630.613]) were independently associated with XDR A. baumannii bacteremia. In case group 2, Pitt bacteremia score (aOR, 1.667 [95% CI, 1.265-2.196]) and third-generation cephalosporins (aOR, 2.965 [95% CI, 1.224-7.182]) were independently associated with non-XDR A. baumannii bacteremia. Concurrent infections (aOR, 3.527 [95% CI, 1.479-8.411]), cancer (aOR, 3.172 [95% CI, 1.135-8.865]), and respiratory source (aOR, 2.690 [95% CI, 1.160-6.239]) were associated with an increased risk of 30-day mortality. Survivors received more active empirical therapy (16.7% vs 9.6%; P=157), had fewer cases of XDR bacteremia (45.8% vs 52.6%; P=.452), and received higher median definitive polymyxin B doses (840,000 units vs 700,000 units; P=.339) conclusions. Use of CVC and broad spectrum antibiotics were unique risk factors of XDR A. baumannii bacteremia. Effective antimicrobial stewardship together with use of a CVC bundle may reduce the incidence of these infections. Risk factors of acquisition and mortality may help identify patients for early initiation of polymyxin B therapy. © 2013 by The Society for Healthcare Epidemiology of America. All rights reserved.|
|Source Title:||Infection Control and Hospital Epidemiology|
|Appears in Collections:||Staff Publications|
Show full item record
Files in This Item:
There are no files associated with this item.
checked on May 21, 2018
WEB OF SCIENCETM
checked on May 1, 2018
checked on May 4, 2018
Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.