• J Med Assoc Thai · Mar 2009

    Comparative Study

    Attributable mortality of imipenem-resistant nosocomial Acinetobacter baumannii bloodstream infection.

    • Silom Jamulitrat, Pranee Arunpan, and Parichart Phainuphong.
    • Department of Community Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand. jsilom@medicine.psu.ac.th
    • J Med Assoc Thai. 2009 Mar 1; 92 (3): 413-9.

    BackgroundUncertainty remains concerning the mortality attributable to infections caused by imipenem-resistant acinetobacter baumannii (IRAB). The authors have sought to examine the impact of this resistance on patient mortality.ObjectiveTo evaluate the effects of imipenem resistance on the mortality of patients with Acinetobacter baumannii bloodstream infection.Material And MethodA cohort study was conducted to compare the survival rates between patients with IRAB and imipenem-susceptible A. baumannii (ISAB) bacteremia.ResultsThe present study shows 35 patients (52.2%) in an IRAB group died in hospital compared to 26 patients (19.9%) in an ISAB group (p < 0.001). Multivariate analysis using Cox's proportional hazard model for controlling the confounding effects due to the severity of underlying diseases, inappropriate antibiotic treatment, and primary source of bacteremia show no statistically significant difference in mortality rates between the two groups.ConclusionThe observed higher mortality rate among patients with an IRAB bloodstream infection may not be attributable to imipenem resistance but may in some part be due to a more severe illness, inappropriate antimicrobial therapy, and primary source of infection.

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