Risk factors of multidrug-resistant Acinetobacter baumannii recurrence after successful eradication in ventilated patients

• Main Authors: Chiung-Yu Lin, Yu-Mu Chen, Meng-Chih Lin, Yu-Ping Chang, Tung-Ying Chao, Chin-Chou Wang, Yuh-Chyn Tsai, Lien Shi Shen, Chin-Ling Li, An-Shen Lin
• Format: Article
• Language: English
• Published: Elsevier 2016-04-01
• Series: Biomedical Journal
• Subjects: Multidrug-resistant Acinetobacter baumannii; Chronic respiratory failure; Risk factor; Recurrence
• Online Access: http://www.sciencedirect.com/science/article/pii/S231941701630066X

Background: Clinically, multidrug-resistant Acinetobacter baumannii (MDR-AB) recurrence is found in some patients although identified as successfully eradicated. We aim to discover the characteristics of patients with MDR-AB recurrence in the respiratory tract. Methods: We retrospectively collected 106 chronic respiratory failure patients with MDR-AB harvest in pulmonary secretion culture. Results: MDR-AB was successfully eradicated in 69 patients. Diabetes mellitus (p = 0.030, odds ratio [OR]: 2.7, 95% confidence interval [CI]: 1.1–6.4) and acute respiratory distress syndrome (p = 0.001, OR = 4.8, 95% CI: 1.8–12.7) reduce the MDR-AB eradication rate. Besides, a classification of colonization or infection was made beyond the 69 MDR-AB eradicated patients. In the colonization group, diabetes mellitus (p = 0.009; OR = 5.1, 95% CI: 1.5–17.6) is the only independent factor to increase the recurrence rate. Glycated hemoglobin level is also analyzed for each group to investigate diabetes control effect, but no significant difference found. Conclusions: Diabetes mellitus is a risk factor of MDR-AB recurrence among MDR-AB-colonized patients; the impact of localized pneumonia patch in MDR-AB-infected patients requires further study to be clarified.