PROGNOSTIC FACTORS OF PATIENTS WITH ACINETOBACTER BAUMANNII BACTEREMIA NOSOCOMIAL INFECTION IN HOSPITAL UNIVERSITI SAINS MALAYSIA
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Date
2012
Authors
NUR SOPHIA, RUSLI
Journal Title
Journal ISSN
Volume Title
Publisher
Pusat Pengajian Sains Perubatan Universiti Sains Malaysia
Abstract
INTRODUCTION: Acinetobacter baumannii has emerged as an important and
problematic human pathogen as it is the causative agent of several type of infection
including bacteremia. The research finding on the prognostic factors obtained are
expected to help in management the Acinetobacter baumannii nosocomial infection and
improving the survival rate.
OBJECTIVES: The objectives of this study are to determine the median survival time
of patient with Acinetobacter baumannii bacteremia nosocomial infection, and to
identify the prognostic factors that influenced the mortality among patients with
Acinetobacter baumannii bacteremia infection.
METHODOLOGY: A retrospective record review was conducted involving 130
patients of bacteremia infected with Acinetobacter baumannii in HUSM, from 1st
January 2010 to 31st December 2011. All patients who fulfilled the inclusion and
exclusion criteria were included in the study. Additional follow up was done from 1st
January 2012 until 31st January 2012 (1 month). All the important information on the
variables interest and patients’ survival status until 31st January 2012 were collected and
recorded into data collection form. Kaplan Meier estimator, simple and multiple Cox
Proportional Hazard regression were performed to determine the median survival and
statistical significance of the prognostic factors.
RESULTS: A total of 67 (51.5%) patients died in this study. The overall median
survival time for patient with Acinetobacter baumannii bacteremia in this study was 40
days (95% CI: 31.33, 44.99). After adjusting for other variables, the significant
prognostic factors that influenced the mortality of Acinetobacter baumannii nosocomial
bacteremia in this study were mechanical ventilation (HR= 57.18; 95% CI: 7.79, 419.66;
p-value <0.001) and antibiotic susceptibility (HR= 3.15, 95% CI: 1.69, 5.88; p-value
<0.001).
CONCLUSION: The median survival time for patient with Acinetobacter baumannii
bacteremia in the study was higher (40 days) compared to the previous study. Patients
with A. baumannii bacteremia who needed mechanical ventilation and resistant to
antibiotics were at higher risk of death compared with those who did not need
mechanical ventilation and susceptible to antibiotics. However, other potential
prognostic factor such as invasive procedure, presence of neutropenia, and renal failure
were not identified as the significant prognostic factor in this study.
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Keywords
Medical Statistics