Nosocomial multi-drug resistant Acinetobacter baumannii bloodstream infection: Risk factors and outcome with ampicillin-sulbactam treatment

R. Smolyakov, A. Borer, K. Riesenberg, F. Schlaeffer, M. Alkan, A. Porath, D. Rimar, Y. Almog, J. Gilad

Research output: Contribution to journalArticlepeer-review

134 Scopus citations

Abstract

The emergence of multidrug-resistant (MDR) Acinetobacter baumannii poses a therapeutic problem. The aim of this study was to assess the risk factors for nosocomial MDR- A. baumannii bloodstream infection (BSI) and the efficacy of ampicillin-sulbactam (A/S) in its treatment. Of 94 nosocomial A. baumannii BSI during the year 2000, 54% involved MDR strains, 81% of which were genetically related. Various risk factors for MDR- A. baumannii were found, of which intensive-care unit admission and prior aminoglycoside therapy were independently associated with MDR- A. baumannii acquisition on multivariate analysis. Of MDR- A. baumannii BSI cases, 65% received A/S and 35% inadequate antibiotic therapy, whereas of 43 non-MDR cases, 86% were treated according to susceptibility and 14% inappropriately with antibiotics to which these organisms were resistant. Crude mortality was comparable in the adequately treated groups. Respective mortalities among patients treated adequately and inadequately were 41.4 and 91.7% (p<0.001). Among severely ill patients, A/S therapy significantly decreased the risk of death (P=0.02 OR=7.64). MDR- A. baumannii has become highly endemic in our institution. A/S appears to be one of the last effective and safe empirical resorts for treatment of MDR A. baumannii BSI.

Original languageEnglish
Pages (from-to)32-38
Number of pages7
JournalJournal of Hospital Infection
Volume54
Issue number1
DOIs
StatePublished - 1 May 2003
Externally publishedYes

Keywords

  • Acinetobacter baumannii
  • Ampicillin-sulbactam
  • Antibiotic
  • Bacteraemia
  • Resistance
  • Risk factors

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

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