Acinetobacter baumannii bacteremia is becoming more prevalent and is
associated with increasing morbidity and mortality. Escalating antibacterial resistance further contributes to therapeutic
dilemmas, enhanced infection control support and poorer outcomes in patients infected with these bacteria. A
retrospective analysis of patients whose blood cultures produced A. baumannii from January 2007 through January 2013 was
performed. Data
regarding the epidemiologic features, antimicrobial susceptibility and outcomes
of patients with A. baumannii bacteremia were collected and
analyzed. Sixty A. baumannii isolates each
from a different patient were identified. The Charlson Comorbidity Index (≥3)
was the greatest among patients
with multi-drug resistance (MDR) compared to intermediate drug resistance
(IDR) and pan-sensitive (PS) A. baumannii.
The mean APACHE II scores for MDR, IDR and PS A. baumannii bacteremia were 21, 15 and 11, respectively (P < 0.05, MDR v. PS). Seventy-three percent of the isolates were resistant
to quinolones, 44% to piperacillin/tazobactam, 45% to amikacin, 22% to
imipenem, 0% to ticarcillin/clavulanate, and 0% to polymyxin. Among 28 patients
with MDR A.
baumannii bacteremia, 20 received inadequate empiric treatment, and 16 of these patients died (80%). Of the
remaining eight patients with MDR bacteremia who received adequate empiric
antibiotics, only two died (25%). The
severity of underlying illness, degree of antibiotic resistance and receiving
inadequate initial antibiotic therapy are associated with mortality among
patients with bacteremia due to A.
baumannii.