TABLE 2.
Univariate comparison between 30-day survivors and nonsurvivors in patients with breakthrough Acinetobacter bacteremia during carbapenem therapy
| Characteristica | All (n = 100) | Survivors (n = 43) | Nonsurvivors (n = 57) | P value |
|---|---|---|---|---|
| Demographical characteristics | ||||
| Age (median [IQR]) (yr) | 70.5 (53.25–80.75) | 75 (55–83) | 66 (52–79.5) | 0.215 |
| Male sex | 62 (62.0) | 22 (51.2) | 40 (70.2) | 0.083 |
| Recent ICU stay | 58 (58.0) | 26 (60.5) | 32 (56.1) | 0.819 |
| Bacteremia acquired in ICU | 66 (66.0) | 27 (62.8) | 39 (68.4) | 0.707 |
| Length of hospitalization before bacteremia (median [IQR]) (days) | 21.5 (13.25–36.5) | 25 (15–37) | 21 (11.5–36) | 0.477 |
| Comorbid conditions | ||||
| Alcoholism | 4 (4.0) | 0 (0.0) | 4 (7.0) | 0.132 |
| Liver cirrhosis | 9 (9.0) | 4 (9.3) | 5 (8.8) | 1.000 |
| Chronic obstructive pulmonary disease | 32 (32.0) | 12 (27.9) | 20 (35.1) | 0.585 |
| Chronic kidney disease | 38 (38.0) | 18 (41.9) | 20 (35.1) | 0.629 |
| Type 2 diabetes mellitus | 34 (34.0) | 14 (32.6) | 20 (35.1) | 0.959 |
| Hypertension | 42 (42.0) | 19 (44.2) | 23 (40.4) | 0.857 |
| Coronary artery disease | 17 (17.0) | 10 (23.3) | 7 (12.3) | 0.239 |
| Congestive heart failure | 24 (24.0) | 12 (27.9) | 12 (21.1) | 0.577 |
| Cerebrovascular accident | 19 (19.0) | 11 (25.6) | 8 (14.0) | 0.230 |
| Collagen vascular disease | 4 (4.0) | 3 (7.0) | 1 (1.8) | 0.312 |
| Immunosuppressant therapy | 12 (12.0) | 3 (7.0) | 9 (15.8) | 0.302 |
| Solid tumor | 16 (16.0) | 8 (18.6) | 8 (14.0) | 0.733 |
| Hematological malignancy | 10 (10.0) | 4 (9.3) | 6 (10.5) | 1.000 |
| Chemotherapy | 8 (8.0) | 4 (9.3) | 4 (7.0) | 0.722 |
| Neutropenia | 8 (8.0) | 2 (4.7) | 6 (10.5) | 0.460 |
| Trauma | 4 (4.0) | 3 (7.0) | 1 (1.8) | 0.312 |
| Burn | 1 (1.0) | 1 (2.3) | 0 (0.0) | 0.430 |
| Recent surgery | 25 (25.0) | 14 (32.6) | 11 (19.3) | 0.200 |
| Charlson comorbidity index (median [IQR]) | 4 (2–5.75) | 4 (2–6) | 4 (2–5) | 0.816 |
| Invasive procedures | ||||
| Arterial catheter | 43 (43.0) | 19 (44.2) | 24 (42.1) | 0.997 |
| Central venous catheter | 55 (55.0) | 26 (60.5) | 29 (50.9) | 0.453 |
| Ventilator use | 76 (76.0) | 30 (69.8) | 46 (80.7) | 0.303 |
| Hemodialysis | 20 (20.0) | 9 (20.9) | 11 (19.3) | 1.000 |
| Thoracic drain | 11 (11.0) | 2 (4.7) | 9 (15.8) | 0.109 |
| Abdominal drain | 14 (14.0) | 8 (18.6) | 6 (10.5) | 0.389 |
| Sources of bacteremia | ||||
| Pneumonia | 49 (49.0) | 21 (48.8) | 28 (49.1) | 1.000 |
| Catheter | 20 (20.0) | 6 (14.0) | 14 (24.6) | 0.289 |
| Urinary tract infection | 1 (1.0) | 1 (2.3) | 0 (0.0) | 0.430 |
| Intra-abdominal infection | 6 (6.0) | 2 (4.7) | 4 (7.0) | 0.697 |
| Wound | 2 (2.0) | 2 (4.7) | 0 (0.0) | 0.182 |
| Primary bacteremia | 22 (22.0) | 11 (25.6) | 11 (19.3) | 0.612 |
| Carbapenem therapy before bacteremia | ||||
| Imipenem | 44 (44.0) | 23 (53.5) | 21 (36.8) | 0.145 |
| Meropenem | 53 (53.0) | 18 (41.9) | 35 (61.4) | 0.083 |
| Doripenem | 3 (3.0) | 2 (4.7) | 1 (1.8) | 0.576 |
| Length of carbapenem therapy before bacteremia (median [IQR]) (days) | 9 (5–13) | 9 (4–13) | 9 (5–14) | 0.829 |
| Antimicrobial therapy after bacteremia onsetb | ||||
| Appropriate antimicrobial therapy | 44 (44.0) | 23 (53.5) | 22 (38.6) | 0.201 |
| Continued carbapenem monotherapy | 59 (59.0) | 28 (65.1) | 31 (54.4) | 0.382 |
| Colistin-based therapyc | 19 (19.0) | 8 (18.6) | 11 (19.3) | 1.000 |
| Tigecycline-based therapy | 15 (15.0) | 3 (7.0) | 12 (21.1) | 0.095 |
| Fluoroquinolone-based therapy | 9 (9.0) | 3 (7.0) | 6 (10.5) | 0.728 |
| Sulbactam-based therapy | 5 (5.0) | 3 (7.0) | 2 (3.5) | 0.649 |
| Carbapenem- and colistin-based therapyc | 17 (17.0) | 7 (16.3) | 10 (17.5) | 1.000 |
| Outcome | ||||
| Shock | 34 (34.0) | 11 (25.6) | 23 (40.4) | 0.183 |
| APACHE II score (median [IQR]) | 26 (18–31.75) | 22 (17–29) | 28 (21–33) | 0.014 |
| Species causing bacteremia | ||||
| A. baumannii | 53 (53.0) | 17 (39.5) | 36 (63.2) | 0.032 |
| A. nosocomialis | 30 (30.0) | 15 (34.9) | 15 (26.3) | 0.481 |
| A. pittii | 13 (13.0) | 9 (20.9) | 4 (7.0) | 0.080 |
| A. soli | 2 (2.0) | 1 (2.3) | 1 (1.8) | 1.000 |
| Microbiological characteristics of causative microorganisms | ||||
| Isolates harboring ISAba1-blaOXA-51-like | 22 (22.0) | 8 (18.6) | 13 (22.8) | 0.793 |
| Isolates harboring ISAba1-blaOXA-23-like | 37 (37.0) | 11 (25.6) | 26 (45.6) | 0.065 |
| Isolates harboring IS1008 (or IS1006)-ΔISAba3-blaOXA-58-like | 6 (6.0) | 0 (0.0) | 6 (10.5) | 0.036 |
| Isolates harboring blaOXA-24-like | 11 (11.0) | 6 (14.0) | 5 (8.8) | 0.523 |
| Isolates harboring blaIMP-like | 5 (5.0) | 4 (9.3) | 1 (1.8) | 0.162 |
| Isolates harboring blaVIM-like | 4 (4.0) | 2 (4.7) | 2 (3.5) | 1.000 |
a
Data are presented as the number (%), unless otherwise indicated. IQR, interquartile range; ICU, intensive care unit; APACHE II, Acute Physiology and Chronic Health Evaluation II.
b
An antimicrobial agent (or antimicrobial agents)-based therapy denotes the corresponding antimicrobial agent(s) alone or in combination with other antimicrobial agent(s).
c
Only intravenous colistin was included. Inhaled colistin was not included.