Authors: X Wang L Zhang A Sun X Yang W Sang Y Jiang J Cheng J Wang M Zhou B Chen J Ouyang
Publish Date: 2017/01/18
Volume: 36, Issue: 7, Pages: 1073-1081
Abstract
Acinetobacter baumannii Ab bacteraemia in patients with haematological malignancies is fatal but rarely reported We explored the clinical characteristics drug resistances and prognostic factors in these patients This multicentre retrospective study was conducted at the department of haematology wards of 18 tertiary hospitals in China from January 2014 to June 2015 The total clinical isolates from every source were collected from patients with haematological malignancy Haematological malignancy patients diagnosed with Ab bacteraemia were analysed During the study period 40 patients with Ab bacteraemia were identified accounting for 29 40/1358 of bacteraemia cases of which 25 625 had acute leukaemia AL and 27 675 had neutropaenia Compared with nonneutropaenic patients neutropaenic patients showed higher Acute Physiology and Chronic Health Evaluation APACHE scores and 30day mortality rates p 005 The in vitro antibiotic susceptibility of Ab to colistin was highest at 100 followed by that of tigecycline 9130 and amikacin 7586 Compared with the patients who had carbapenemsusceptible Ab infections patients infected with carbapenemresistant Ab CRAB had significantly longer hospital stays and were more likely to have had exposure to carbapenem before bacteraemia p 005 The 30day mortality rate was 325 CRAB neutropaenia higher APACHE score Pitt bacteraemia score and inappropriate initial antimicrobial therapy were significantly associated with 30day mortality Multivariable analysis showed that APACHE score and CRAB were independent predictors of 30day mortality Haematologic patients with AL and febrile neutropaenia were at high risk of Ab bacteraemia More attention should be paid to CRAB which is an independent risk factor for mortality in haematological malignancy patients with Ab bacteraemiaAll procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards
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