Analysis of risk factors on 28-day mortality for Acinetobacter Baumannii infection

Qiu Ze-liang; Shen Kan; Xu Dong-wei; Li Hong-peng; Li Xiu-hua; Zou Chun-hua; Jiang Jian-xin

doi:10.3969/j.issn.1002-1949.2017.03.010

Abstract：Objective To explore the risk factors on prognosis of Acinetobacter Baumannii infection.Methods Clinical data from 95 patients with Acinetobacter Baumannii infection hospitalized in Zhoupu Hospital Affiliated to Shanghai University of Medicine & Health Sciences from January 2014 to January 2015 were analyzed retrospectively.According to the 28-day prognosis after admission,the patients were divided into non-survivors and survivors.Data on demographic and clinical characteristics,wards,underlying diseases,specimen source,severity of infection,invasive medical procedures,bacterial resistance to antibiotic,and acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score in the beginning were collected.The index as an independent risk factor of morality was demonstrated by multivariate Cox regression analysis.The prognosis was compared by Kaplan-Meier survival analysis.Results During the study period,21 491 patients were admitted to the hospital.Of them,95 (4.56‰) patients were infected by Acinetobacter Baumannii.The 28-day mortality was 26.32％ (31/66).The multivariate Cox proportional model revealed that septic shock (RR 2.75,95％ CI 1.16～ 6.54,P =0.02) and carbapenem-resistant Acinetobacter Baumannii (CRAB) infection (RR 2.84,95％ CI 1.07 ～ 7.52,P =0.04) were independent predictors of the 28-day prognosis in patients with Acinetobacter Baumannii infection.Kaplan-Meier survival analysis also showed that subjects in the CRAB group had a shorter mean survival time than those in the CSAB group (22.32 d vs.26.25 d respectively,P =0.002).A similar phenomenon for mean survival time was observed when the subjects were divided by septic shock or not (septic shock group:19.27 d,without septic shock group:25.25 d,P =0.000).Conclusion CRAB infection or not and severity of infection presentation are major risk factors for mortality in patients with Acinetobacter baumannii infection.