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Article

Acinetobacter baumannii Infections in Hospitalized Patients, Treatment Outcomes

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Pharmacy Department, Sohar Hospital, Sohar 311, Oman
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General Medicine Department, Sohar Hospital, Sohar 311, Oman
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Gehan Harb Statistics, Cairo 11511, Egypt
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Cleveland Clinic Abu Dhabi, Abu-Dhabi P.O. Box 112412, United Arab Emirates
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Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, OH 44195, USA
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Philadelphia College of Pharmacy, University of the Sciences, Philadelphia, PA 19104, USA
*
Author to whom correspondence should be addressed.
Academic Editor: Albert Figueras
Received: 1 April 2021 / Revised: 18 May 2021 / Accepted: 21 May 2021 / Published: 25 May 2021
Background Acinetobacter baumannii (AB), an opportunistic pathogen, could develop into serious infections with high mortality and financial burden. The debate surrounding the selection of effective antibiotic treatment necessitates studies to define the optimal approach. This study aims to compare the clinical outcomes of commonly used treatment regimens in hospitalized patients with AB infections to guide stewardship efforts. Material and methods: Ethical approval was obtained, 320 adult patients with confirmed AB infections admitted to our tertiary care facility within two years were enrolled. The treatment outcomes were statistically analyzed to study the relation between antibiotic regimens and 14, 28, and 90-day mortality as the primary outcomes using binary logistic regression—using R software—in addition to the length of hospitalization, adverse events due to antibiotic treatment, and 90-day recurrence as secondary outcomes. Results: Among 320 patients, 142 (44%) had respiratory tract, 105 (33%) soft tissue, 42 (13%) urinary tract, 22 (7%) bacte iemia, and other infections 9 (3%). Nosocomial infections were 190 (59%) versus community-acquired. Monotherapy was significantly associated with lower 28-day (p < 0.05, OR:0.6] and 90-day (p < 0.05, OR:0.4) mortality rates, shorter length of stay LOS (p < 0.05, Median: −12 days] and limited development of adverse events (p < 0.05, OR:0.4). Subgroup analysis revealed similar results ranging from lower odds of mortality, adverse events, and shorter LOS to statistically significant correlation to monotherapy. Meropenem (MEM) and piperacillin/tazobactam (PIP/TAZ) monotherapies showed non-significant high odd ratios of mortalities, adverse events, and disparate LOS. There was a statistical correlation between most combined therapies and adverse events, and longer LOS. Colistin based and colistin/meropenem (CST/MEM) combinations were superior in terms of 14-day mortality (p = 0.05, OR:0.4) and (p < 0.05, OR:0.4) respectively. Pip/Taz and MEM-based combined therapies were associated with statistically non-significant high odd ratios of mortalities. Tigecycline (TGC)-based combinations showed a significant correlation to mortalities (p < 0.05, OR:2.5). Conclusion: Monotherapy was associated with lower mortality rates, shorter LOS, and limited development of adverse events compared to combined therapies. Colistin monotherapy, colistin/meropenem, and other colistin combinations showed almost equivalent mortality outcomes. Patients on combined therapy were more susceptible to adverse events and comparable LOS. The possible adverse outcomes of PIP/TAZ and MEM-based therapies in the treatment of MDRAB infections and the association of TGC with a higher mortality rate raise doubts about their treatment role. View Full-Text
Keywords: Acinetobacter baumannii; mortality; treatment outcomes; antimicrobial; resistance; adverse events; recurrence; LOS; treatment regimens; colistin; tigecycline Acinetobacter baumannii; mortality; treatment outcomes; antimicrobial; resistance; adverse events; recurrence; LOS; treatment regimens; colistin; tigecycline
MDPI and ACS Style

Alrahmany, D.; Omar, A.F.; Harb, G.; El Nekidy, W.S.; Ghazi, I.M. Acinetobacter baumannii Infections in Hospitalized Patients, Treatment Outcomes. Antibiotics 2021, 10, 630. https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics10060630

AMA Style

Alrahmany D, Omar AF, Harb G, El Nekidy WS, Ghazi IM. Acinetobacter baumannii Infections in Hospitalized Patients, Treatment Outcomes. Antibiotics. 2021; 10(6):630. https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics10060630

Chicago/Turabian Style

Alrahmany, Diaa, Ahmed F. Omar, Gehan Harb, Wasim S. El Nekidy, and Islam M. Ghazi 2021. "Acinetobacter baumannii Infections in Hospitalized Patients, Treatment Outcomes" Antibiotics 10, no. 6: 630. https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics10060630

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