Influence of severity of infection on the effect of appropriate antimicrobial therapy for Acinetobacter baumannii bacteremic pneumonia

Autor:	Chorng-Kuang How, Ya-Sung Yang, Aristine Cheng, Te-Li Chen, Yung-Chih Wang, Chang-Pan Liu, Shu-Chen Kuo, Yuag-Meng Liu, Yi-Tzu Lee, Fang-Yu Kang
Jazyk:	angličtina
Rok vydání:	2020
Předmět:	Microbiology (medical) Male Acinetobacter baumannii medicine.medical_specialty Bacteremia Drug resistance Severity of Illness Index Severity lcsh:Infectious and parasitic diseases Internal medicine Medicine Humans Pharmacology (medical) lcsh:RC109-216 Mortality Aged APACHE II biology Appropriate antimicrobial therapy business.industry Mortality rate Research Public Health Environmental and Occupational Health Odds ratio Pneumonia Antimicrobial medicine.disease biology.organism_classification Anti-Bacterial Agents Infectious Diseases Logistic Models Multivariate Analysis Female business Acinetobacter Infections
Zdroj:	Antimicrobial Resistance and Infection Control, Vol 9, Iss 1, Pp 1-11 (2020) Antimicrobial Resistance and Infection Control
ISSN:	2047-2994
Popis:	Background The impact of appropriate antimicrobial therapy for A. baumannii bacteremic pneumonia has not been well established due to the inclusion of the three phenotypically indistinguishable Acinetobacter species and confounding factors including underlying diseases and severity of infection. This retrospective study aimed to evaluate the impact of appropriate antimicrobial therapy on 14-day mortality in A. baumannii bacteremic pneumonia patients after adjusting for risk factors. Methods This study was conducted at five medical centers in Taiwan between July 2012 and June 2016. A. baumannii species identification was performed using reference molecular methods. Risk factors for 14-day mortality were analyzed via logistic regression. The interaction between the Acute Physiology and Chronic Health Evaluation (APACHE) II score and appropriate antimicrobial therapy was assessed using the logistic model. Results A total of 336 patients with monomicrobial A. baumannii bacteremic pneumonia were included in this study. The overall 14-day mortality rate was 47.3%. The crude mortality of appropriate antimicrobial therapy was 35.9% (57 of 151 patients). Appropriate antimicrobial therapy was associated with a lower mortality after multivariate adjustment (odds ratio [OR], 0.57; 95% confidence interval [CI], 0.34–0.97; p = 0.04), and the effect was influenced by APACHE II score (OR for interaction term, 0.0098; 95% CI, 0.0005–0.1885; p = 0.002). Further analysis demonstrated that appropriate antimicrobial therapy significantly reduced 14-day mortality among the patients with an APACHE II score > 35 (OR 0.0098; 95% CI 0.0005–0.1885). Conclusion Appropriate antimicrobial therapy decreases 14-day mortality of the most severely ill patients with A. baumannii bacteremic pneumonia.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::823135f1a0887209de528ae47658dd82 http://link.springer.com/article/10.1186/s13756-020-00824-4 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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