Meta-analysis of Risk Factors for Mortality in Patients with Acinetobacter Baumannii Bloodstream Infection

Xu Han; Haiyan Huang; Weitao Lv; Wanxian Lu

doi:doi:10.11648/j.ajns.20211001.22

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Meta-analysis of Risk Factors for Mortality in Patients with Acinetobacter Baumannii Bloodstream Infection

Xu Han, Haiyan Huang, Weitao Lv, Wanxian Lu

Published in American Journal of Nursing Science (Volume 10, Issue 1)

Received: 7 February 2021 Accepted: 17 February 2021 Published: 23 February 2021

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Abstract

Background: Patients with Acinetobacter baumannii bloodstream infection (ABBI) have a poor prognosis and high mortality. Early identification of risk factors for death in patients with ABBI, and appropriate prevention and control measures are extremely important to reduce the mortality. Objective: To systematically evaluate the risk factors of ABBI, which provide evidence for reducing the incidence and mortality of patients. Methods: The published articles and reference works on prognosis risk factors in patients with ABBI were retrieved from inception to January 2021 in the following databases: PubMed, Web of Science, Embase, CNKI, Wanfang and VIP. Those studies that met the inclusion criteria were perform quality evaluation and data analysis. Meta-analysis was performed by the statistical software Stata13.0. Results: A total of 24 articles were included, including 1 203 patients in the death group and 1 319 patients in the survival group. Among the 24 included study factors, 15 showed statistically significant differences(P<0.01), including: age (MD=0.19, 95%CI: 0.08~0.30, P<0.01), APACHE II (MD=0.48, 95%CI: 0.06~0.91, P=0.03), ICU admission (OR=1.91, 95%CI: 1.12~3.26, P=0.02), shock (OR=4.28, 95% CI: 1.05~17.49, P=0.04), septic shock (OR=8.36, 95%CI: 3.71~18.82, P<0.01), renal damage (OR=1.57, 95%CI: 1.19~2.07, P<0.01), diabetes (OR=1.31,95%CI: 1.03~1.68, P=0.03), malignant tumor (OR=1.56, 95%CI: 1.02~2.37, P=0.04 ), liver disease (OR=1.93, 95%CI: 1.25~3.00, P<0.01), hormonal used (OR=5.46, 95%CI: 3.12~9.56, P<0.01), immunosuppression (OR=2.73, 95%CI: 1.82~4.1, P<0.01 ), mechanical ventilation (OR=3.17, 95%CI: 2.34~4.29, P<0.01), deep vein catheterization (OR=2.02, 95%CI: 1.56~2.61, P<0.01), indwelling urinary catheter (OR =2.53, 95%CI: 1.66~3.84, P<0.01), indwelling gastric tube (OR=1.79, 95%CI: 1.21~2.65, P<0.01). Conclusion: The severity of the patient's underlying disease, using of hormones and immunosuppressants, and various invasive operations were the main risk factors for high mortality in ABBI patients. It was necessary to focus on older patients, dynamically monitor the APACHE II score, carefully evaluate the effect of hormone and immunosuppressant application, and strictly control the indications of invasive operation or treatment.

Published in	American Journal of Nursing Science (Volume 10, Issue 1)
DOI	10.11648/j.ajns.20211001.22
Page(s)	64-70
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Acinetobacter Baumannii, Bloodstream Infection, Risk Factors, Mortality, Meta-analysis

References

[1]	Kim SY, Cho SI, Bang JH. Risk factors associated with bloodstream infection among patients colonized by multidrug-resistant Acinetobacter baumannii: A 7-year observational study in a general hospital. Am J Infect Control. 2020; 48 (5): 581-583.
[2]	Zhang Y, Du M, Johnston JM, et al. Estimating length of stay and inpatient charges attributable to hospital-acquired bloodstream infections. Antimicrob Resist Infect Control. 2020; 9 (1): 137. Published 2020 Aug 18.
[3]	Karakonstantis S, Gikas A, Astrinaki E, Kritsotakis EI. Excess mortality due to pandrug-resistant Acinetobacter baumannii infections in hospitalized patients. J Hosp Infect. 2020; 106 (3): 447-453.
[4]	Liu Q, Li W, Du X, et al. Risk and Prognostic Factors for Multidrug-Resistant Acinetobacter Baumannii Complex Bacteremia: A Retrospective Study in a Tertiary Hospital of West China. PLoS One. 2015; 10 (6): e0130701. Published 2015 Jun 17.
[5]	Yu K, Zeng W, Xu Y, et al. Bloodstream infections caused by ST2 Acinetobacter baumannii: risk factors, antibiotic regimens, and virulence over 6 years period in China. Antimicrob Resist Infect Control. 2021;10 (1): 16. Published 2021 Jan 18.
[6]	Gu Y, Jiang Y, Zhang W, et al. Risk factors and outcomes of bloodstream infections caused by Acinetobacter baumannii: a case-control study. Diagn Microbiol Infect Dis. 2021; 99 (2): 115229.
[7]	Zhou H, Yao Y, Zhu B, et al. Risk factors for acquisition and mortality of multidrug-resistant Acinetobacter baumannii bacteremia: A retrospective study from a Chinese hospital. Medicine (Baltimore). 2019; 98 (13): e14937.
[8]	Papadimitriou-Olivgeris M, Fligou F, Spiliopoulou A, et al. Risk factors and predictors of carbapenem-resistant Pseudomonas aeruginosa and Acinetobacter baumannii mortality in critically ill bacteraemic patients over a 6-year period (2010-15): antibiotics do matter. J Med Microbiol. 2017; 66 (8): 1092-1101.
[9]	Ballouz T, Aridi J, Afif C, et al. Risk Factors, Clinical Presentation, and Outcome of Acinetobacter baumannii Bacteremia. Front Cell Infect Microbiol. 2017; 7: 156. Published 2017 May 4.
[10]	Wang X, Zhang L, Sun A, et al. Acinetobacter baumannii bacteraemia in patients with haematological malignancy: a multicentre retrospective study from the Infection Working Party of Jiangsu Society of Hematology. Eur J Clin Microbiol Infect Dis. 2017; 36 (7): 1073-1081.
[11]	Yanyan Z, Wan Z, Jingping Z, et al. The risk factors associated with bloodstream infections caused by multi-drugresistant Acinetobacter baumannii. Chin J Infect Chemother, 2017, 17 (02): 134-139.
[12]	Zhang Y, Gao XD, Bi-Jie H, et al. Risk factors of mortality in patients with bloodstream infections due to Acinetobacter baumannii. Chin J Nosocomio, 2017, 27 (12): 2668-2671.
[13]	Gu Z, Han Y, Meng T, et al. Risk Factors and Clinical Outcomes for Patients With Acinetobacter baumannii Bacteremia. Medicine (Baltimore). 2016; 95 (9): e2943.
[14]	Lee YT, Chiang MC, Kuo SC, et al. Carbapenem Breakpoints for Acinetobacter baumannii Group: Supporting Clinical Outcome Data from Patients with Bacteremia. PLoS One. 2016; 11 (9): e0163271. Published 2016 Sep 19.
[15]	Liu CP, Shih SC, Wang NY, et al. Risk factors of mortality in patients with carbapenem-resistant Acinetobacter baumannii bacteremia. J Microbiol Immunol Infect. 2016; 49 (6): 934-940.
[16]	Guo N, Xue W, Tang D, Ding J, Zhao B. Risk factors and outcomes of hospitalized patients with blood infections caused by multidrug-resistant Acinetobacter baumannii complex in a hospital of Northern China. Am J Infect Control. 2016; 44 (4): e37-e39.
[17]	Freire MP, de Oliveira Garcia D, Garcia CP, et al. Bloodstream infection caused by extensively drug-resistant Acinetobacter baumannii in cancer patients: high mortality associated with delayed treatment rather than with the degree of neutropenia. Clin Microbiol Infect. 2016 Apr; 22 (4): 352-358.
[18]	Long Y, Guo QH, Liu DW, et al. Risk Factors and Clinical Outcomes of Pan-drug Resistant Acinetobacter baumannii Bacteremia. Med J PUMCH, 2015, 6 (04): 260-266.
[19]	Nutman A, Glick R, Temkin E, et al. A case-control study to identify predictors of 14-day mortality following carbapenem-resistant Acinetobacter baumannii bacteraemia. Clin Microbiol Infect. 2014; 20 (12): O1028-O1034.
[20]	Park SY, Choo JW, Kwon SH, et al. Risk Factors for Mortality in Patients with Acinetobacter baumannii Bacteremia. Infect Chemother. 2013; 45 (3): 325-330.
[21]	Kim SY, Jung JY, Kang YA, Lim JE, Kim EY, Lee SK, et al. Risk factors for occurrence and 30-day mortality for carbapenem-resistant Acinetobacter baumannii bacter- emia in an intensive care unit. J Korean Med Sci 2012; 27: 939-47.
[22]	Esterly JS, Griffith M, Qi C, et al. Impact of carbapenem resistance and receipt of active antimicrobial therapy on clinical outcomes of Acinetobacter baumannii bloodstream infections. Antimicrob Agents Chemother. 2011; 55 (10): 4844-4849.
[23]	Song JY, Cheong HJ, Choi WS, et al. Clinical and microbiological characterization of carbapenem-resistant Acinetobacter baumannii bloodstream infections. J Med Microbiol. 2011; 60 (Pt 5): 605-611.
[24]	Anunnatsiri S, Tonsawan P. Risk factors and clinical outcomes of multidrug-resistant Acinetobacter baumannii bacteremia at a university hospital in Thailand. Southeast Asian J Trop Med Public Health. 2011; 42 (3): 693-703.
[25]	Routsi C, Pratikaki M, Platsouka E, et al. Carbapenem-resistant versus carbapenem-susceptible Acinetobacter baumannii bacteremia in a Greek intensive care unit: risk factors, clinical features and outcomes. Infection. 2010; 38 (3): 173-180.
[26]	Tseng YC, Wang JT, Wu FL, Chen YC, Chie WC, Chang SC. Prognosis of adult patients with bacteremia caused by extensively resistant Acinetobacter baumannii. Diagn Microbiol Infect Dis. 2007; 59 (2): 181-190.
[27]	Choi JY, Park YS, Kim CO, et al. Mortality risk factors of Acinetobacter baumannii bacteraemia. Intern Med J. 2005; 35 (10): 599-603.
[28]	He S, Li Z, Yang Q, Quan M, Zhao L, Hong Z. Resistance Trends Among 1,294 Nosocomial Acinetobacter baumannii Strains from a Tertiary General Hospital in China, 2014 - 2017. Clin Lab. 2020; 66 (3): 10.7754/Clin.Lab.2019.190629.
[29]	Knaus WA, Draper EA, Wagner DP, Zimmerman JE. APACHE II: a severity of disease classification system. Crit Care Med. 1985; 13 (10): 818-829.
[30]	Uwingabiye J, Lemnouer A, Baidoo S, et al. Intensive care unit-acquired Acinetobacter baumannii infections in a Moroccan teaching hospital: epidemiology, risk factors and outcome. Germs. 2017; 7 (4): 193-205.
[31]	Xiao D, Wang L, Zhang D, Xiang D, Liu Q, Xing X. Prognosis of patients with Acinetobacter baumannii infection in the intensive care unit: A retrospective analysis. Exp Ther Med. 2017; 13 (4): 1630-1633.
[32]	El Mekes A, Zahlane K, Ait Said L, Tadlaoui Ouafi A, Barakate M. The clinical and epidemiological risk factors of infections due to multi-drug resistant bacteria in an adult intensive care unit of University Hospital Center in Marrakesh-Morocco. J Infect Public Health. 2020; 13 (4): 637-643.

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APA Style

Xu Han, Haiyan Huang, Weitao Lv, Wanxian Lu. (2021). Meta-analysis of Risk Factors for Mortality in Patients with Acinetobacter Baumannii Bloodstream Infection. American Journal of Nursing Science, 10(1), 64-70. https://doi.org/10.11648/j.ajns.20211001.22

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ACS Style

Xu Han; Haiyan Huang; Weitao Lv; Wanxian Lu. Meta-analysis of Risk Factors for Mortality in Patients with Acinetobacter Baumannii Bloodstream Infection. Am. J. Nurs. Sci. 2021, 10(1), 64-70. doi: 10.11648/j.ajns.20211001.22

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AMA Style

Xu Han, Haiyan Huang, Weitao Lv, Wanxian Lu. Meta-analysis of Risk Factors for Mortality in Patients with Acinetobacter Baumannii Bloodstream Infection. Am J Nurs Sci. 2021;10(1):64-70. doi: 10.11648/j.ajns.20211001.22

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@article{10.11648/j.ajns.20211001.22,
  author = {Xu Han and Haiyan Huang and Weitao Lv and Wanxian Lu},
  title = {Meta-analysis of Risk Factors for Mortality in Patients with Acinetobacter Baumannii Bloodstream Infection},
  journal = {American Journal of Nursing Science},
  volume = {10},
  number = {1},
  pages = {64-70},
  doi = {10.11648/j.ajns.20211001.22},
  url = {https://doi.org/10.11648/j.ajns.20211001.22},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajns.20211001.22},
  abstract = {Background: Patients with Acinetobacter baumannii bloodstream infection (ABBI) have a poor prognosis and high mortality. Early identification of risk factors for death in patients with ABBI, and appropriate prevention and control measures are extremely important to reduce the mortality. Objective: To systematically evaluate the risk factors of ABBI, which provide evidence for reducing the incidence and mortality of patients. Methods: The published articles and reference works on prognosis risk factors in patients with ABBI were retrieved from inception to January 2021 in the following databases: PubMed, Web of Science, Embase, CNKI, Wanfang and VIP. Those studies that met the inclusion criteria were perform quality evaluation and data analysis. Meta-analysis was performed by the statistical software Stata13.0. Results: A total of 24 articles were included, including 1 203 patients in the death group and 1 319 patients in the survival group. Among the 24 included study factors, 15 showed statistically significant differences(PPP=0.03), ICU admission (OR=1.91, 95%CI: 1.12~3.26, P=0.02), shock (OR=4.28, 95% CI: 1.05~17.49, P=0.04), septic shock (OR=8.36, 95%CI: 3.71~18.82, PPP=0.03), malignant tumor (OR=1.56, 95%CI: 1.02~2.37, P=0.04 ), liver disease (OR=1.93, 95%CI: 1.25~3.00, PPPPPPP<0.01). Conclusion: The severity of the patient's underlying disease, using of hormones and immunosuppressants, and various invasive operations were the main risk factors for high mortality in ABBI patients. It was necessary to focus on older patients, dynamically monitor the APACHE II score, carefully evaluate the effect of hormone and immunosuppressant application, and strictly control the indications of invasive operation or treatment.},
 year = {2021}
}

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TY  - JOUR
T1  - Meta-analysis of Risk Factors for Mortality in Patients with Acinetobacter Baumannii Bloodstream Infection
AU  - Xu Han
AU  - Haiyan Huang
AU  - Weitao Lv
AU  - Wanxian Lu
Y1  - 2021/02/23
PY  - 2021
N1  - https://doi.org/10.11648/j.ajns.20211001.22
DO  - 10.11648/j.ajns.20211001.22
T2  - American Journal of Nursing Science
JF  - American Journal of Nursing Science
JO  - American Journal of Nursing Science
SP  - 64
EP  - 70
PB  - Science Publishing Group
SN  - 2328-5753
UR  - https://doi.org/10.11648/j.ajns.20211001.22
AB  - Background: Patients with Acinetobacter baumannii bloodstream infection (ABBI) have a poor prognosis and high mortality. Early identification of risk factors for death in patients with ABBI, and appropriate prevention and control measures are extremely important to reduce the mortality. Objective: To systematically evaluate the risk factors of ABBI, which provide evidence for reducing the incidence and mortality of patients. Methods: The published articles and reference works on prognosis risk factors in patients with ABBI were retrieved from inception to January 2021 in the following databases: PubMed, Web of Science, Embase, CNKI, Wanfang and VIP. Those studies that met the inclusion criteria were perform quality evaluation and data analysis. Meta-analysis was performed by the statistical software Stata13.0. Results: A total of 24 articles were included, including 1 203 patients in the death group and 1 319 patients in the survival group. Among the 24 included study factors, 15 showed statistically significant differences(PPP=0.03), ICU admission (OR=1.91, 95%CI: 1.12~3.26, P=0.02), shock (OR=4.28, 95% CI: 1.05~17.49, P=0.04), septic shock (OR=8.36, 95%CI: 3.71~18.82, PPP=0.03), malignant tumor (OR=1.56, 95%CI: 1.02~2.37, P=0.04 ), liver disease (OR=1.93, 95%CI: 1.25~3.00, PPPPPPP<0.01). Conclusion: The severity of the patient's underlying disease, using of hormones and immunosuppressants, and various invasive operations were the main risk factors for high mortality in ABBI patients. It was necessary to focus on older patients, dynamically monitor the APACHE II score, carefully evaluate the effect of hormone and immunosuppressant application, and strictly control the indications of invasive operation or treatment.
VL  - 10
IS  - 1
ER  -

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Author Information

Xu Han

Department of Intensive Care Unit, The First Affiliated Hospital of Jinan University, Guangzhou, China
Haiyan Huang

Department of Intensive Care Unit, The First Affiliated Hospital of Jinan University, Guangzhou, China
Weitao Lv

Department of Intensive Care Unit, The First Affiliated Hospital of Jinan University, Guangzhou, China
Wanxian Lu

Department of Intensive Care Unit, The First Affiliated Hospital of Jinan University, Guangzhou, China

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APA Style

Xu Han, Haiyan Huang, Weitao Lv, Wanxian Lu. (2021). Meta-analysis of Risk Factors for Mortality in Patients with Acinetobacter Baumannii Bloodstream Infection. American Journal of Nursing Science, 10(1), 64-70. https://doi.org/10.11648/j.ajns.20211001.22

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ACS Style

Xu Han; Haiyan Huang; Weitao Lv; Wanxian Lu. Meta-analysis of Risk Factors for Mortality in Patients with Acinetobacter Baumannii Bloodstream Infection. Am. J. Nurs. Sci. 2021, 10(1), 64-70. doi: 10.11648/j.ajns.20211001.22

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AMA Style

Xu Han, Haiyan Huang, Weitao Lv, Wanxian Lu. Meta-analysis of Risk Factors for Mortality in Patients with Acinetobacter Baumannii Bloodstream Infection. Am J Nurs Sci. 2021;10(1):64-70. doi: 10.11648/j.ajns.20211001.22

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@article{10.11648/j.ajns.20211001.22,
  author = {Xu Han and Haiyan Huang and Weitao Lv and Wanxian Lu},
  title = {Meta-analysis of Risk Factors for Mortality in Patients with Acinetobacter Baumannii Bloodstream Infection},
  journal = {American Journal of Nursing Science},
  volume = {10},
  number = {1},
  pages = {64-70},
  doi = {10.11648/j.ajns.20211001.22},
  url = {https://doi.org/10.11648/j.ajns.20211001.22},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajns.20211001.22},
  abstract = {Background: Patients with Acinetobacter baumannii bloodstream infection (ABBI) have a poor prognosis and high mortality. Early identification of risk factors for death in patients with ABBI, and appropriate prevention and control measures are extremely important to reduce the mortality. Objective: To systematically evaluate the risk factors of ABBI, which provide evidence for reducing the incidence and mortality of patients. Methods: The published articles and reference works on prognosis risk factors in patients with ABBI were retrieved from inception to January 2021 in the following databases: PubMed, Web of Science, Embase, CNKI, Wanfang and VIP. Those studies that met the inclusion criteria were perform quality evaluation and data analysis. Meta-analysis was performed by the statistical software Stata13.0. Results: A total of 24 articles were included, including 1 203 patients in the death group and 1 319 patients in the survival group. Among the 24 included study factors, 15 showed statistically significant differences(PPP=0.03), ICU admission (OR=1.91, 95%CI: 1.12~3.26, P=0.02), shock (OR=4.28, 95% CI: 1.05~17.49, P=0.04), septic shock (OR=8.36, 95%CI: 3.71~18.82, PPP=0.03), malignant tumor (OR=1.56, 95%CI: 1.02~2.37, P=0.04 ), liver disease (OR=1.93, 95%CI: 1.25~3.00, PPPPPPP<0.01). Conclusion: The severity of the patient's underlying disease, using of hormones and immunosuppressants, and various invasive operations were the main risk factors for high mortality in ABBI patients. It was necessary to focus on older patients, dynamically monitor the APACHE II score, carefully evaluate the effect of hormone and immunosuppressant application, and strictly control the indications of invasive operation or treatment.},
 year = {2021}
}

Copy | Download

TY  - JOUR
T1  - Meta-analysis of Risk Factors for Mortality in Patients with Acinetobacter Baumannii Bloodstream Infection
AU  - Xu Han
AU  - Haiyan Huang
AU  - Weitao Lv
AU  - Wanxian Lu
Y1  - 2021/02/23
PY  - 2021
N1  - https://doi.org/10.11648/j.ajns.20211001.22
DO  - 10.11648/j.ajns.20211001.22
T2  - American Journal of Nursing Science
JF  - American Journal of Nursing Science
JO  - American Journal of Nursing Science
SP  - 64
EP  - 70
PB  - Science Publishing Group
SN  - 2328-5753
UR  - https://doi.org/10.11648/j.ajns.20211001.22
AB  - Background: Patients with Acinetobacter baumannii bloodstream infection (ABBI) have a poor prognosis and high mortality. Early identification of risk factors for death in patients with ABBI, and appropriate prevention and control measures are extremely important to reduce the mortality. Objective: To systematically evaluate the risk factors of ABBI, which provide evidence for reducing the incidence and mortality of patients. Methods: The published articles and reference works on prognosis risk factors in patients with ABBI were retrieved from inception to January 2021 in the following databases: PubMed, Web of Science, Embase, CNKI, Wanfang and VIP. Those studies that met the inclusion criteria were perform quality evaluation and data analysis. Meta-analysis was performed by the statistical software Stata13.0. Results: A total of 24 articles were included, including 1 203 patients in the death group and 1 319 patients in the survival group. Among the 24 included study factors, 15 showed statistically significant differences(PPP=0.03), ICU admission (OR=1.91, 95%CI: 1.12~3.26, P=0.02), shock (OR=4.28, 95% CI: 1.05~17.49, P=0.04), septic shock (OR=8.36, 95%CI: 3.71~18.82, PPP=0.03), malignant tumor (OR=1.56, 95%CI: 1.02~2.37, P=0.04 ), liver disease (OR=1.93, 95%CI: 1.25~3.00, PPPPPPP<0.01). Conclusion: The severity of the patient's underlying disease, using of hormones and immunosuppressants, and various invasive operations were the main risk factors for high mortality in ABBI patients. It was necessary to focus on older patients, dynamically monitor the APACHE II score, carefully evaluate the effect of hormone and immunosuppressant application, and strictly control the indications of invasive operation or treatment.
VL  - 10
IS  - 1
ER  -

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