The Investigation of Risk Factors for Acinetobacter baumannii Complex in Elderly Patients and Laboratory Data

• Main Authors: Shan-Fan Chow, 周尚芳
• Other Authors: Dey-Chyi Sheu
• Format: Others
• Published: 2015
• Online Access: http://ndltd.ncl.edu.tw/handle/93295585150441508274

博士 === 大同大學 === 生物工程學系(所) === 103 === The mortality risk factors in elderly patients (≥ 65 y) and laboratory data with carbapenem-resistant Acinetobacter baumannii (CRAB) complex bacteremia are poorly understood. The aim of this study is to identify the mortality risk factors among elderly patients and the laboratory data associated with CRAB complex bacteremia. A retrospective study of patients with CRAB complex bacteremia in a MacKay Memorial Hospital (MMH) from 2009 to 2013 was performed. Variables such as clinical characteristics, antimicrobial susceptibilities, and outcomes were compared between elderly patients (≥ 65 y) and the other patients (< 65 y). As the same time, laboratory variables, such as hemoglobin, platelet, albumin and creatinine etc. were analyzed. Two hundreds patients with CRAB complex bacteremia were enrolled. Excluding incomplete medical records, there were 195 patients conducted. Risk factors for mortality among elderly patients (67/121, 55.37%) with CRAB complex bacteremia included APACHE II (Acute Physiologic and Chronic Health Evaluation II) score > 25 (OR 6.702, p = 0.001), respiratory tract source (OR 4.416, p = 0.026), and cefepime (OR 13.203, p = 0.023). During this period, excluding incomplete laboratory parameters from 195 patients, there were 144 non-duplicated CRAB complex blood isolates were available for the analysis of biochemical and hematological parameters. The finding was that APACHE II score, respiratory tract source, and low albumin level were the risk factors for the attributable mortality. Furthermore, especially in 101 elderly patients with complete biochemical and hematological parameters, the risk factors for attributable mortality were APACHE II score, low albumin levels, low hematocrit levels and low platelet counts were risk factors for attributable mortality. This study demonstrated that CRAB complex bacteremia in elderly patients (≥ 65 y) had a distinct epidemiology compared to the other patients (< 65 y). Early management with albumin supply or correction of anemia that had hypoalbuminemia or anemia in CRAB complex bacteremia elderly patients may influence improvement of outcome.