Characteristics and Outcomes of <i>Acinetobacter baumannii</i> Infections in Critically Ill Patients with Cancer: A Matched Case–Control Study

Nazer, Lama; Kharabsheh, Asma; Rimawi, Dalia; Mubarak, Sawsan; Hawari, Feras

doi:10.1089/mdr.2015.0032

Cited by 30 publications

(29 citation statements)

References 20 publications

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“…Previous studies have highlighted on the importance of a patient's immune status on the outcome, with prolonged LOS and mortality rates, particularly when a hematological malignancy is present (Nazer et al, 2015; Gu et al, 2016). Though we did not find any significant association between malignancies and mortality, exposure to high dose steroids increased the risk of dying by 7.4-folds.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors, Clinical Presentation, and Outcome of Acinetobacter baumannii Bacteremia

Ballouz

Aridi

Afif

et al. 2017

Front. Cell. Infect. Microbiol.

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Infections caused by Acinetobacter baumannii (AB), an increasingly prevalent nosocomial pathogen, have been associated with high morbidity and mortality. We conducted this study to analyze the clinical features, outcomes, and factors influencing the survival of patients with AB bacteremia. We retrospectively examined the medical records of all patients developing AB bacteremia during their hospital stay at a tertiary care hospital in Beirut between 2010 and 2015. Ninety episodes of AB bacteremia were documented in eighty-five patients. Univariate analysis showed that prior exposure to high dose steroids, diabetes mellitus, mechanical ventilation, prior use of colistin and tigecycline, presence of septic shock, and critical care unit stay were associated with a poor outcome. High dose steroids and presence of septic shock were significant on multivariate analysis. Crude mortality rate was 63.5%. 70.3% of the deaths were attributed to the bacteremia. On acquisition, 39 patients had septicemia. Despite high index of suspicion and initiation of colistin and/or tigecycline in 18/39 patients, a grim outcome could not be averted and 37 patients died within 2.16 days. Seven patients had transient benign bacteremia; three of which were treated with removal of the line. The remaining four did not receive any antibiotics due to withdrawal of care and died within 26.25 days of acquiring the bacteremia, with no signs of persistent infection on follow up. A prolonged hospital stay is frequently associated with loss of functionality, and steroid and antibiotic exposure. These factors seem to impact the mortality of AB bacteremia, a disease with high mortality rate and limited therapeutic options.

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Section: Discussionmentioning

confidence: 99%

Risk Factors, Clinical Presentation, and Outcome of Acinetobacter baumannii Bacteremia

Ballouz

Aridi

Afif

et al. 2017

Front. Cell. Infect. Microbiol.

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“…Additionally, hospitalized patients were at increased risk for colonization with AB (90%; P=0.026) when compared to outpatients (10%) with A. baumannii (Table 3). Recent studies from Jordan and other countries reported that A. Baumannii frequently colonizes hospitalized patients, causing sporadic invasive infection and nosocomial outbreaks, especially among critically ill patients and in ICUs [2,[25][26][27].…”

Section: Discussionmentioning

confidence: 99%

“…This study demonstrates that the majority of A. baumannii species isolates were resistant in the range between 76% to 100% to commonly useful antimicrobial agents in the treatment of gram-negative infections, including infections due to A. baumannii (Table 4). Previous studies which has been performed over the last few years at the Jordan University Hospital and KHCC in Amman, have also found that the majority of A. baumannii isolates from patients and hospital environment sources was also multidrug resistant [2,3,28].…”

Section: Discussionmentioning

confidence: 99%

“…In recent years worldwide including Jordan, most clinical A. baumannii isolates have developed resistant to most clinically used drugs, and caused increased morbidity and mortality among hospitalized patients in intensive care units (ICUs) [1][2][3][4].…”

Section: Introductionmentioning

confidence: 99%

“…However, the rates of antibiotic resistance vary from region to region and among hospitals [12]. Almost all studies indicate that MDR A. baumannii infections are difficult to treat, spread quickly among hospitalized patients and can be associated with high mortality due to blood sepsis or ventilator associated pneumonia [2,4,[12][13][14].…”

Section: Introductionmentioning

confidence: 99%

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Occurrence and molecular characterization of metallo-β-lactamases (MBLs) among Acinetobacter baumannii isolates from cancer patients

qouzah

Hawari²,

Abu-Qatouseh

et al. 2018

int. arab. j antimicrob. agents

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Background: During the last decade, the prevalence of carbapenem-resistant infection associated with multidrug resistant (MDR) Acinetobacter baumanniiin patients has been continuously increasing. This prospective study aimed to determine the occurrence and molecular characterization of metallo-β-lactamases (MBLs) and carbapenem hydrolyzing oxacillinases among A. baumannii isolates from cancer patients over a period of 6-month. Methods:Antimicrobial susceptibility profile of 70 randomly collected A. baumannii isolates was first determined using disc diffusion test, and second, the MICs of 45 representative multidrug resistant (MDR) isolates were tested to useful drugs in treatment of their infections using E-test. PCR assays were used to detect the common four types of class D carbapenem hydrolyzing oxacillinases, two types of class A carbapenemases, four types of class B metallo-β –lactamases, and prevalence of Class 1 Integron among MDR isolates. Results: All 70 isolates were MDR, including 100% resistance to meropenom, aztreonem, piperacillin/tazobactum and 99% to carbapenem. All isolates carried blaOXA-23 and blaOXA-51, but none carried a blaOXA-24 like or blaOXA-58. The isolates also were positive for NDM-1, NDM, VIM, GES, KPC and SPM at the rates of 29%, 20%, 29%,19%,7% and 2%, respectively. Class 1 Integron was positive in 82% of A. baumanniiisolates. The clonal relationship of 42 MDR A. baumanniiisolates using ERIC-PCR and constructed dendrogram showed 3 major genotype clusters of genetically related isolates. These include 4 genotype groups, each composed of 2 isolates with 100 % similarity of DNA bands. Conclusion:This study demonstrates that A. baumannii colonize frequently cancer patients in association with antibiotic treatment. The organism is mostly carrying wide spectrum of antibiotic resistance genetic factors, especially many types of ESBLs and MBLs and Class 1 Integron. This fact should be considered when therapy is selected for treatment of patients infected with MDR A. baumannii. Key words. Acinetobacter baumannii, ESBLs, MBLs, Class 1 Integron, Jordanian cancer patients.

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Antimicrobial Resistance in the Arab Region

Rizk¹,

Kanj²

2021

Handbook of Healthcare in the Arab World

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Characteristics and Outcomes of Acinetobacter baumannii Infections in Critically Ill Patients with Cancer: A Matched Case–Control Study

Abstract: AB infections in critically ill cancer patients were independently associated with increased mortality and increased ICU LOS. Measures to improve the outcomes of critically ill cancer patients infected with AB are necessary.

Cited by 30 publications

References 20 publications

Risk Factors, Clinical Presentation, and Outcome of Acinetobacter baumannii Bacteremia

Risk Factors, Clinical Presentation, and Outcome of Acinetobacter baumannii Bacteremia

Occurrence and molecular characterization of metallo-β-lactamases (MBLs) among Acinetobacter baumannii isolates from cancer patients

Antimicrobial Resistance in the Arab Region

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