Journal List > Ann Clin Microbiol > v.26(2) > 1516087181

Chung, Hahm, and Lee: Risk factors associated with colistin-resistant Acinetobacter baumannii infection

Abstract

Acinetobacter baumannii is an important cause of healthcare-associated infections and is resistant to almost all antimicrobial agents, with strains recently reported to be resistant to colsitin. In this study, we aimed to identify the risk factors associated with colistin-resistant A. baumannii infections by comparing colistin-resistant and -susceptible A. baumannii isolates. We retrospectively reviewed the medical records of 51 and 100 cases in which colistinresistant and -susceptible A. baumannii were isolated, respectively. Univariate analysis showed that compared with patients with colistin-sensitive infections, patients with colistinresistant A. baumanni infections had a combined pulmonary disease (P = 0.017), were admitted to intensive care unit (P = 0.020), and had prior mechanical ventilation (P = 0.003), tracheostomy (P = 0.043), percutaneous drainage (P = 0.070), hemodialysis (P = 0.002); use of colistin (P = 0.000), carbapenem (P = 0.000), and teicoplanin (P = 0.004); and co-infection (P = 0.035). Multivariate analysis indicated that eight variables were related to the likelihood of colistin-resistant A. baumanni infections: use of teicoplanin (Odds ratio [OR]: 3.140, 95% confidence interval [CI]: 0.529–18.650), prior hemodialysis (OR: 2.722, 95% CI: 0.851–8.709), combined pulmonary disease (OR: 2.286, 95% CI: 0.998–5.283), prior use of carbapenem (OR: 0.199, 95% CI: 0.863–5.603), co-infection (OR: 1.706, 95% CI: 0.746–3.898), prior mechanical ventilation (OR: 1.614, 95% CI, 0.684–3.809), intensive care unit admission (OR: 1.387, 95% CI: 0.560–3.435), and prior tracheostomy (OR: 1.102, 95% CI: 0.344–3.527); however, no statistical differences were observed. Although colistin use could not be proven in multivariate analysis, the possibility of being a risk factor cannot be ruled out.

[in Korean]

Ethics statement

This study was approved by the institutional review board of Ewha Womans University Mokdong Hospital (IRB No. EUMC 2019-09-013-003). The board exempted the obtainment of informed consent.

Conflicts of interest

Hae-Sun Chung has been an editor-in-chief of the Annals of Clinical Microbiology since January 2022. However, she was not involved in the review process of this article. No other potential conflict of interest relevant to this article was reported.

Funding

This research was supported by EWHA Education and Research Center for Infection Research Fund, grant number 201900610001. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

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Table 1
Antimicrobial resistance of colistin-resistant A. baumannii and colistin-susceptible A. baumannii groups
ACM-2602-01-t1.png
Table 2
Univariate analysis of risk factor for development of colistin-resistant A. baumannii infection
ACM-2602-01-t2.png

Values are presented as the median (range) or n (%) or n.

*Other bacteria are isolated from the same or other samples within 3 days of A. baumannii isolation.

Abbreviation: ICU, intensive care unit.

Table 3
Multivariate analysis of risk factor for development of colistin-resistant A. baumannii infection
ACM-2602-01-t3.png

*Other bacteria are isolated from the same or other samples within 3 days of A. baumannii isolation.

Abbreviations: OR, odds ratio; CI, confidence interval; ICU, intensive care unit.

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