Risk factors for occurrence and 30-day mortality for carbapenem-resistant Acinetobacter baumannii bacteremia in an intensive care unit

Song Yee Kim, Ji Ye Jung, youngae kang, Joo Eun Lim, Eun Young Kim, Sang Kook Lee, Seon Cheol Park, Kyung Soo Chung, Byung Hoon Park, Young Sam Kim, Se Kyu Kim, Joon Chang, Moo Suk Park

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Abstract

To assess the risk factors for carbapenem-resistant Acinetobacter baumannii (CRAB) bacteremia and for 30-day mortality in patients with CRAB bacteremia in the intensive care unit (ICU), we conducted a retrospective study in the ICU at Severance Hospital in Korea from January 2008 to December 2009. Patients who acquired CRAB bacteremia in the ICU were enrolled as the case group and patients whose specimens of blood culture, sputum/endotracheal aspirate and urine revealed no AB were enrolled as controls. The case group comprised 106 patients and 205 patients were included as controls. Risk factors independently associated with CRAB bacteremia included prior chemotherapy or radiotherapy treatment (Odds ratio [OR], 3.6; P = 0.003), recent central venous catheter insertion (OR, 5.7; P < 0.001) or abdominal drainage insertion (OR, 21.9; P = 0.004), the number of antibiotics treated with (OR, 1.3; P = 0.016), and respiratory failure in the ICU (OR, 2.5; P = 0.035). The 30-day mortality was 79.8%. Renal failure during ICU stay was independently associated with 30-day mortality (OR, 3.7; P = 0.047). It is important to minimize invasive procedures, and to restrict excessive use of antibiotics, especially in immunocompromised patients, in order to prevent the development of CRAB bacteremia. Greater concern for CRAB bacteremia patients is needed when renal failure develops during ICU stay.

Original languageEnglish
Pages (from-to)939-947
Number of pages9
JournalJournal of Korean medical science
Volume27
Issue number8
DOIs
Publication statusPublished - 2012 Aug 1

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Acinetobacter baumannii
Carbapenems
Bacteremia
Intensive Care Units
Odds Ratio
Mortality
Renal Insufficiency
Anti-Bacterial Agents
Central Venous Catheters
Immunocompromised Host
Korea
Sputum
Respiratory Insufficiency
Drainage
Radiotherapy
Retrospective Studies
Urine
Drug Therapy

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Kim, Song Yee ; Jung, Ji Ye ; kang, youngae ; Lim, Joo Eun ; Kim, Eun Young ; Lee, Sang Kook ; Park, Seon Cheol ; Chung, Kyung Soo ; Park, Byung Hoon ; Kim, Young Sam ; Kim, Se Kyu ; Chang, Joon ; Park, Moo Suk. / Risk factors for occurrence and 30-day mortality for carbapenem-resistant Acinetobacter baumannii bacteremia in an intensive care unit. In: Journal of Korean medical science. 2012 ; Vol. 27, No. 8. pp. 939-947.
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title = "Risk factors for occurrence and 30-day mortality for carbapenem-resistant Acinetobacter baumannii bacteremia in an intensive care unit",
abstract = "To assess the risk factors for carbapenem-resistant Acinetobacter baumannii (CRAB) bacteremia and for 30-day mortality in patients with CRAB bacteremia in the intensive care unit (ICU), we conducted a retrospective study in the ICU at Severance Hospital in Korea from January 2008 to December 2009. Patients who acquired CRAB bacteremia in the ICU were enrolled as the case group and patients whose specimens of blood culture, sputum/endotracheal aspirate and urine revealed no AB were enrolled as controls. The case group comprised 106 patients and 205 patients were included as controls. Risk factors independently associated with CRAB bacteremia included prior chemotherapy or radiotherapy treatment (Odds ratio [OR], 3.6; P = 0.003), recent central venous catheter insertion (OR, 5.7; P < 0.001) or abdominal drainage insertion (OR, 21.9; P = 0.004), the number of antibiotics treated with (OR, 1.3; P = 0.016), and respiratory failure in the ICU (OR, 2.5; P = 0.035). The 30-day mortality was 79.8{\%}. Renal failure during ICU stay was independently associated with 30-day mortality (OR, 3.7; P = 0.047). It is important to minimize invasive procedures, and to restrict excessive use of antibiotics, especially in immunocompromised patients, in order to prevent the development of CRAB bacteremia. Greater concern for CRAB bacteremia patients is needed when renal failure develops during ICU stay.",
author = "Kim, {Song Yee} and Jung, {Ji Ye} and youngae kang and Lim, {Joo Eun} and Kim, {Eun Young} and Lee, {Sang Kook} and Park, {Seon Cheol} and Chung, {Kyung Soo} and Park, {Byung Hoon} and Kim, {Young Sam} and Kim, {Se Kyu} and Joon Chang and Park, {Moo Suk}",
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Kim, SY, Jung, JY, kang, Y, Lim, JE, Kim, EY, Lee, SK, Park, SC, Chung, KS, Park, BH, Kim, YS, Kim, SK, Chang, J & Park, MS 2012, 'Risk factors for occurrence and 30-day mortality for carbapenem-resistant Acinetobacter baumannii bacteremia in an intensive care unit', Journal of Korean medical science, vol. 27, no. 8, pp. 939-947. https://doi.org/10.3346/jkms.2012.27.8.939

Risk factors for occurrence and 30-day mortality for carbapenem-resistant Acinetobacter baumannii bacteremia in an intensive care unit. / Kim, Song Yee; Jung, Ji Ye; kang, youngae; Lim, Joo Eun; Kim, Eun Young; Lee, Sang Kook; Park, Seon Cheol; Chung, Kyung Soo; Park, Byung Hoon; Kim, Young Sam; Kim, Se Kyu; Chang, Joon; Park, Moo Suk.

In: Journal of Korean medical science, Vol. 27, No. 8, 01.08.2012, p. 939-947.

Research output: Contribution to journalArticle

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T1 - Risk factors for occurrence and 30-day mortality for carbapenem-resistant Acinetobacter baumannii bacteremia in an intensive care unit

AU - Kim, Song Yee

AU - Jung, Ji Ye

AU - kang, youngae

AU - Lim, Joo Eun

AU - Kim, Eun Young

AU - Lee, Sang Kook

AU - Park, Seon Cheol

AU - Chung, Kyung Soo

AU - Park, Byung Hoon

AU - Kim, Young Sam

AU - Kim, Se Kyu

AU - Chang, Joon

AU - Park, Moo Suk

PY - 2012/8/1

Y1 - 2012/8/1

N2 - To assess the risk factors for carbapenem-resistant Acinetobacter baumannii (CRAB) bacteremia and for 30-day mortality in patients with CRAB bacteremia in the intensive care unit (ICU), we conducted a retrospective study in the ICU at Severance Hospital in Korea from January 2008 to December 2009. Patients who acquired CRAB bacteremia in the ICU were enrolled as the case group and patients whose specimens of blood culture, sputum/endotracheal aspirate and urine revealed no AB were enrolled as controls. The case group comprised 106 patients and 205 patients were included as controls. Risk factors independently associated with CRAB bacteremia included prior chemotherapy or radiotherapy treatment (Odds ratio [OR], 3.6; P = 0.003), recent central venous catheter insertion (OR, 5.7; P < 0.001) or abdominal drainage insertion (OR, 21.9; P = 0.004), the number of antibiotics treated with (OR, 1.3; P = 0.016), and respiratory failure in the ICU (OR, 2.5; P = 0.035). The 30-day mortality was 79.8%. Renal failure during ICU stay was independently associated with 30-day mortality (OR, 3.7; P = 0.047). It is important to minimize invasive procedures, and to restrict excessive use of antibiotics, especially in immunocompromised patients, in order to prevent the development of CRAB bacteremia. Greater concern for CRAB bacteremia patients is needed when renal failure develops during ICU stay.

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