Predictors of mortality in patients infected with carbapenem-resistant Acinetobacter baumannii: A systematic review and meta-analysis.

Authors:
Xinfeng Xu
Xinfeng Xu
The First Affiliated Hospital of Nanjing Medical University
Jing Yao
Jing Yao
China Pharmaceutical University
China
Sixia Chen
Sixia Chen
Taishan Medical College
China
Ziyan Shen
Ziyan Shen
College of Chemistry and Materials Science
Xi'an | China
Lihua Yang
Lihua Yang
State Key Laboratory of Environmental Aquatic Chemistry
Ganzhu Feng
Ganzhu Feng
Nanjing Medical University
China

Am J Infect Control 2019 Apr 16. Epub 2019 Apr 16.

Department of Respiratory Medicine, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, China. Electronic address:

Background: Carbapenem-resistant Acinetobacter baumannii (CRAB) tops the list of threats to human health. Studies exploring predictors of mortality in patients with CRAB infection produced conflicting results.

Methods: A systematic search of the PubMed, Embase, and the Cochrane Library databases was performed from inception to June 2018 to identify studies reporting mortality predictors in patients infected with CRAB. Two authors independently assessed trials for inclusion and data extraction.

Results: A total of 19 observational studies were enrolled in this study. Factors associated with mortality of patients infected with CRAB were inappropriate empirical antimicrobial treatment (odds ratio [OR], 5.04; 95% confidence interval [CI], 2.56-9.94), septic shock (OR, 5.65; 95% CI, 2.35-13.57), chronic liver disease (OR, 2.36; 95% CI, 1.33-4.16), chronic renal disease (OR, 2.02; 95% CI, 1.37-2.99), hypertension (OR, 1.74; 95% CI, 1.08-2.80), neutropenia (OR, 3.31; 95% CI, 1.25-8.77), immunosuppressant use (OR, 3.15; 95% CI, 1.94-5.11), total parenteral nutrition (OR, 1.66; 95% CI, 1.08-2.56), and intubation (OR, 5.03; 95% CI, 2.33-10.87). Acute Physiology and Chronic Health Evaluation II score at admission and Pitt bacteremia score at the onset of CRAB bacteremia were higher in nonsurvivors.

Conclusions: Our study suggests that severity of baseline condition and receiving inappropriate experience antibiotic therapy are major risk factors for higher mortality in patients with CRAB infections. These findings may help clinicians to take appropriate preventive measures and decrease mortality in such patients.

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.ajic.2019.03.003DOI Listing
April 2019
5 Reads

Publication Analysis

Top Keywords

mortality patients
20
patients infected
12
95%
9
infected crab
8
predictors mortality
8
carbapenem-resistant acinetobacter
8
acinetobacter baumannii
8
patients crab
8
patients
6
crab
6
mortality
5
odds ratio
4
treatment odds
4
95% 194-511
4
antimicrobial treatment
4
suggests severity
4
study suggests
4
physiology chronic
4
[or] 504
4
95% confidence
4

Altmetric Statistics

Similar Publications