Impact of appropriate antimicrobial therapy on survival in patients with Acinetobacter baumannii-associated infections

Abstract

Objective: To assess the impact of inappropriate antimicrobial treatment on the 30-day mortality in patients with Acinetobacter baumannii associated infections. Methods: 87 patients with nosocomial infections caused by A. baumannii were included in the study. Among them 39 patients had favorable outcome, while 48 patients died within 30 days after pathogen isolation. In order to assess the impact of antimicrobial therapy on outcomes, the cases with appropriate antimicrobial treatment from both studied groups were compared with the cases in which patient\'s received inappropriate therapy. The Chi-square or Z-test was used to assess differences in categorical variables. Continuous variables were compared using the Mann-Whitney test. Results: Among patients with favorable outcomes four people received appropriate empirical antimicrobial treatment, while in the other group only three patients. The odds ratio was 1.7 (95% CI 0.4-8.2; p=0.77). Appropriate antimicrobial agents were administered as a part of causal treatment to 27 patients who survived and to 11 patients who died within 30 days after pathogen isolation. The odds ratio was 6.7 (95% CI 2.6-17.3; p<0.001). Conclusion: Our study has revealed that appropriate causal antimicrobial therapy decreases 30-day mortality rate in patients with nosocomial infections caused by A. baumannii.

Keywords

• Acinetobacter

Impact of appropriate antimicrobial therapy on survival in patients with Acinetobacter baumannii-associated infections

Öz

Amaç: Acinetobacter baumannii ilişkili enfeksiyonları olan hastalarda uygunsuz antimikrobiyal tedavinin 30 günlük mortaliteye etkisini değerlendirmek Yöntemler: A. baumannii ’nin neden olduğu 87 hastane enfeksiyonlu hasta çalışmaya dahil edildi. Hastalardan 39’unda olumlu sonuç alınırken 48 hasta patojen izolasyondan sonraki 30 gün içinde öldü. Antimikrobiyal tedavinin akıbet üzerine etkisini değerlendirmek amacıyla, çalışılan gruplardan uygun antimikrobiyal tedavi ile uygunsuz tedavi alan hastalar karşılaştırıldı. Kategorik değişkenlerin farklılıklarını değerlendirmek için Ki-kare veya Z-testi kullanıldı. Sürekli değişkenler Mann-Whitney testi ile karşılaştırıldı.Bulgular: Olumlu sonuçları olan hastalardan sadece dört kişi uygun ampirik antibiyotik tedavisi alırken diğer grupta bu yalnız üç hastaydı. Odds oranı 1,7 (% 95 CI 0,4-8,2, p=0,77) idi. Temel tedavinin bir parçası olarak uygun antimikrobiyal ajanlar uygulanarak tedavi verilen 27 hasta yaşarken, patojen izolasyondan sonra 30 gün içinde 11 hasta öldü. Odds oranı 6,7 (% 95 CI 2,6-17,3; p <0.001) idi.Sonuç: Bizim çalışmamız; nedene yönelik uygun antibiyotik tedavisinin A. baumannii’ye bağlı hastane enfeksiyonları olan hastalarda 30 günlük mortalite oranını azalttığını ortaya koymuştur

Anahtar Kelimeler

• Acinetobacter baumannii, mortalite, antimikrobial tedavi, nozokomiyal infeksion

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