Table 1.
Thirty day mortality-associated factors for patients with an Acinetobacter baumannii BSI.
| Variables | Total* | Survival | 30-day death† | P‡ | Univariate model | |
|---|---|---|---|---|---|---|
| n = 181 | n = 104 | n = 77 | HR [95%CI]§ | P | ||
| Demographic information | ||||||
| Male | 115 (63.5%) | 67 (64.4%) | 48 (62.3%) | 0.876 | 0.883 [0.557–1.400] | 0.596 |
| Age | 67.7 ± 14.3 | 64.5 ± 15.5 | 72.1 ± 11.1 | <0.001 | 1.033 [1.014–1.054] | <0.001 |
| Inpatients | 172 (95%) | 98 (94.2%) | 74 (96.1%) | 0.735 | 1.355 [0.427–4.298] | 0.606 |
| Hospital origin | 160 (88.4%) | 87 (83.7%) | 73 (94.8%) | 0.033 | 2.808 [1.026–7.685] | 0.044 |
| Intensive care unit | 117 (64.6%) | 63 (60.6%) | 54 (70.1%) | 0.210 | 1.342 [0.824–2.187] | 0.238 |
| Underlying disease¶ | ||||||
| Charlson index | 4.1 ± 2.2 | 3.9 ± 2.2 | 4.4 ± 2.2 | 0.108 | 1.086 [0.981–1.202] | 0.112 |
| Solid tumor | 48 (26.5%) | 27 (26.0%) | 21 (27.3%) | 0.866 | 1.183 [1.109–1.261] | <0.001 |
| Diabetes mellitus | 42 (23.2%) | 28 (26.9%) | 14 (18.2%) | 0.213 | 0.049 [0.000–7177] | 0.620 |
| Cerebrovascular disease | 33 (18.2%) | 23 (22.1%) | 10 (13.0%) | 0.125 | 0.597 [0.307–1.161] | 0.129 |
| Kidney disease | 25 (13.8%) | 15 (14.4%) | 10 (13.0%) | 0.831 | 1.043 [0.631–1.722] | 0.870 |
| Chronic pulmonary diseases | 12 (6.6%) | 7 (6.7%) | 5 (6.5%) | >0.999 | 6.176 [0.840–45.40] | 0.074 |
| Chronic liver diseases | 7 (3.9%) | 2 (1.9%) | 5 (6.5%) | 0.137 | 2.182 [0.878–5.420] | 0.093 |
| Dementia | 9 (5.0%) | 5 (4.8%) | 4 (5.2%) | >0.999 | 1.069 [0.432–2.649] | 0.885 |
| Other# | 5 (2.8%) | 2 (1.9%) | 3 (3.9%) | 0.652 | 1.019 [0.372–2.787] | 0.971 |
| Severity variables | ||||||
| SOFA score | 5.9 ± 3.5 | 4.8 ± 3.2 | 7.4 ± 3.5 | <0.001 | 1.183 [1.109–1.261] | <0.001 |
| Lab data | ||||||
| WBC | 11.5 ± 7.8 | 12.2 ± 6.9 | 10.6 ± 8.8 | 0.185 | 0.967 [0.934–1.000] | 0.052 |
| Hb | 10.4 ± 7.8 | 10.9 ± 10.4 | 9.6 ± 1.6 | 0.262 | 0.910 [0.788–1.051] | 0.201 |
| Platelet | 169.7 ± 132.1 | 206.9 ± 138.3 | 119.5 ± 104.8 | <0.001 | 0.994 [0.991–0.997] | <0.001 |
| Origin of infection¶ | ||||||
| Pulmonary tract | 69 (38.1%) | 36 (34.6%) | 33 (42.9%) | 0.281 | 1.259 [0.801–1.978] | 0.317 |
| Wound | 7 (3.9%) | 5 (4.8%) | 2 (2.6%) | 0.700 | 0.653 [0.160–2.662] | 0.553 |
| Urinary tract | 4 (2.2%) | 4 (3.8%) | 0 (0%) | 0.138 | 0.048 [0.000–18.92] | 0.319 |
| Causative pathogen | ||||||
| Polymicrobial infection | 44 (24.3%) | 30 (28.8%) | 14 (18.2%) | 0.116 | 0.636 [0.356–1.135] | 0.125 |
| ICLII†† | 153 (84.5%) | 83 (79.8%) | 70 (90.9%) | 0.060 | 2.083 [0.958–4.533] | 0.064 |
| ST191 (1-3-3-2-2-94-3) | 73 (40.3%) | 29 (27.9%) | 44 (57.1%) | <0.001 | 2.630 [1.671–4.139] | <0.001 |
| ST784 (1-3-3-2-2-107-3) | 31 (17.1%) | 17 (16.3%) | 14 (18.2%) | 0.842 | 0.983 [0.551–1.755] | 0.954 |
| ST451 (1-3-3-2-2-142-3) | 29 (16.0%) | 24 (23.1%) | 5 (6.5%) | 0.004 | 0.293 [0.118–0.727] | 0.008 |
| Virulence factors | ||||||
| Bacterial lipocalin, Blc | 145 (80.1%) | 79 (76.0%) | 66 (85.7%) | 0.132 | 1.540 [0.813–2.916] | 0.185 |
| Pro-apoptotic porin, PorB | 146 (80.7%) | 79 (76.0%) | 67 (87.0%) | 0.086 | 1.839 [0.946–3.575] | 0.073 |
| Small protein A, SmpA | 177 (97.8%) | 101 (97.1%) | 76 (98.7%) | 0.638 | 1.773 [0.247–12.75] | 0.569 |
| Pili, Csu | 73 (40.3%) | 45 (43.3%) | 28 (36.4%) | 0.363 | 0.781 [0.491–1.243] | 0.297 |
| PNAG, Pga | 173 (95.6%) | 96 (92.3%) | 77 (100%) | 0.022 | 22.02 [0.307–1579] | 0.156 |
| Polysaccharide exporter, EpsA | 9 (5.0%) | 7 (6.7%) | 2 (2.6%) | 0.305 | 0.425 [0.104–1.730] | 0.232 |
| Capsule protein, MviM | 7 (3.9%) | 4 (3.8%) | 3 (3.9%) | >0.999 | 1.047 [0.330–3.322] | 0.938 |
| Lipopolysaccharide, VipA | 16 (8.8%) | 9 (8.7%) | 7 (9.1%) | >0.999 | 1.021 [0.469–2.220] | 0.959 |
| Lipopolysaccharide, Wzx | 48 (26.5%) | 26 (25%) | 22 (28.6%) | 0.613 | 1.144 [0.698–1.875] | 0.595 |
| Glyconokinase, GntK | 179 (98.9%) | 102 (98.1%) | 77 (100%) | 0.508 | 20.54 [0.004–93770] | 0.482 |
| Quorum Sensing, LuxR | 159 (87.8%) | 91 (87.5%) | 68 (88.3%) | >0.999 | 1.000 [0.499–2.004] | 0.999 |
| Motility and secretion, PilA | 18 (9.9%) | 12 (11.5%) | 6 (7.8%) | 0.460 | 0.723 [0.314–1.664] | 0.446 |
| Siderophore, BasD | 179 (98.9%) | 102 (98.1%) | 77 (100%) | 0.508 | 20.54 [0.004–93770] | 0.482 |
| Antimicrobial resistance | ||||||
| Penicillins NS | 157 (86.7%) | 82 (78.8%) | 75 (97.4%) | <0.001 | 7.352 [1.804–29.96] | 0.005 |
| 3-, 4- gen. cephalosporins NS | 162 (89.5%) | 85 (81.7%) | 77 (100%) | <0.001 | 25.33 [1.463–438.6] | 0.026 |
| Carbapenems NS | 160 (88.4%) | 84 (80.8%) | 76 (98.7%) | <0.001 | 13.15 [1.828–94.63] | 0.010 |
| Aminoglycosides NS | 141 (77.9%) | 76 (73.1%) | 65 (84.4%) | 0.073 | 1.515 [0.818–2.805] | 0.187 |
| Fluoroquinolones NS | 162 (89.5%) | 85 (81.7%) | 77 (100%) | <0.001 | 25.33 [1.463–438.6] | 0.026 |
| Tetracyclines NS | 13 (7.2%) | 11 (10.6%) | 2 (2.6%) | 0.045 | 0.284 [0.070–1.156] | 0.079 |
| Drug susceptible | 18 (9.9%) | 18 (17.3%) | 0 (0%) | <0.001 | 0.040 [0.002–0.743] | 0.031 |
| MDR/XDR | 162 (89.5%) | 85 (81.7%) | 77 (100%) | <0.001 | 25.33 [1.463–438.6] | 0.026 |
| Treatment | ||||||
| Adequate empirical therapy | 49 (27.1%) | 30 (28.8%) | 19 (24.7%) | 0.613 | 0.744 [0.443–1.249] | 0.263 |
| Definitive therapy within 72 h | 49 (27.1%) | 39 (37.5%) | 10 (13.0%) | <0.001 | 0.246 [0.124–0.488] | <0.001 |
*
The percentage was calculated from the total number of AB-BSI.
†
All-cause mortality within 30 days from the initial blood culture.
‡
P value is either from Pearson's X2 test for categorical data or from the t-test for continuous data. Bonferroni corrected significance level from 32 hypotheses was considered to be P <0.0016, and the significant P values are indicated in bold.
§
Cox proportional hazards regression model was applied to calculate the hazard ratio (HR) and the 95% confidence interval (CI).
¶
Underlying disease and primary site of infection could be multiple by patient.
#
Ulcer (n = 2), connective tissue disease (n = 2), congestive cardiac insufficiency (n = 2), and leukemia (n = 2) are included.
††
Multilocus sequence typing profiles are indicated with the combination of alleles (gltA-gyrB-gdhB-recA-cpn60-gpi-rpoD).
SD, standard deviation; ICLII, the international clonal lineage II.