Treatment Outcomes and Risk Factors Related to Mortality and Treatment Failure of Patients Infected with Acinetobacter baumannii at a General Hospital

Main Article Content

Wichai Santimaleeworagun
Wandee Sumret
Kittinun Likitmongkonsuk
Piyachet Noo-in
Penpitcha Cheeaboonkana
Amontheera Suphannavej
Juthathip Suphanklang
Weerayuth Saelim

Abstract







OBJECTIVES: This retrospective study aimed to explore clinical outcomes and risk factors associated with mortality and treatment failure among A. baumannii infected patients.


MATERIAL AND METHODS: This retrospective study gathered the data of patients infected with A. baumannii, during the period from January 2014 to December 2015, admitted at Hua Hin hospital. Patient data reviewed included demographic data, antimicrobial regimens, antimicrobial susceptibility, length of hospitalization, source of infections, and clinical outcomes. The primary outcome measurements were in-hospital mortality and risk factors related to failure and mortality.


RESULT: One hundred and forty-five patients were included in the study. Of our results, pneumonia was the most common site of infection (80.7%). The in-hospital mortality and treatment failure rates were 43.4% and 52.4%, respectively. For logistic regression analysis, shock was a statistically significant risk factor associated with treatment failure (adjusted odd ratios 3.10, 95%CI 1.21-7.97) and in-hospital mortality (aOR 4.96; 95%CI 1.74-14.14). Whereas age ≥ 65 years (aOR 2.21; 95% 1.06-4.64) was only associated with in-hospital mortality.


CONCLUSION: Septic shock and patients aged ≥ 65 years old were associated with unfavourable treatment outcomes in patients with A. baumannii infections. Thus, this critical condition needs to be addressed and measures taken to improve outcomes of A. baumannii treatment.







Article Details

How to Cite
1.
Santimaleeworagun W, Sumret W, Likitmongkonsuk K, Noo-in P, Cheeaboonkana P, Suphannavej A, Suphanklang J, Saelim W. Treatment Outcomes and Risk Factors Related to Mortality and Treatment Failure of Patients Infected with Acinetobacter baumannii at a General Hospital. BKK Med J [Internet]. 2019 Oct. 24 [cited 2024 Mar. 28];15(2):154. Available from: https://he02.tci-thaijo.org/index.php/bkkmedj/article/view/222818
Section
Original Article

References

1. World Health Organization. Global Tuberculosis Report 2018.Executive Summary. Geneva. Switzerland. 2018
2. Rajeswari R, Balasubramanian R, Muniyandi M, et al.Socio-economic impact of tuberculosis on patients andfamily in India. Int J Tuberc Lung Dis 1919;3(10):869-77.
3. Zenner D, Loutet MG, Harris R, et al. Evaluation of 17 yearsof LTBI screening in North West England: A retrospectivecohort study of reactivation. Eur Respir J 2017;50:1602505.
4. Houben RMGJ, Dodd PJ, The Global Burden of LatentTuberculosis Infection: A Re- estimation using mathematicalmodeling. PloS Med 2016;13(10):e1002152.
5. Rissel NL, Belcher BW, Bushyhead JB et al. The Accuracyof Tuberculin Skin Test: Self-Assessment by Adult Outpatients.Public Health Rep. July- August 1985; 100(4): 439-445
6. Lee E, Holzman RS. Evolution and Current Use of theTuberculin Test. Clin Infect Dis 2002;34:365-70
7. Yi L, Sasaki Y, Nagai H, et al. Evaluation of QuantiFERON-TBGold Plus for detection of Mycobacterium tuberculosisinfection in Japan. Sci Rep 2016;6:30617.
8. Azghay M, Bouchaud O, Mechai F et al. Utility of QuantiREFON-TB Gold In-Tube assay in adult, pulmonary andextrapulmonary, active tuberculosis diagnosis. Int J Infect Dis2016;44:25-30.
9. Kim HW, Kim JS. Treatment of Latent Tuberculosis Infectionand Its Clinical Efficacy. Tuberc Respi Dis (Seoul)2018;81(1):6-12.
10. Luetkemeyer AF, Charlebois ED, Flores LL et al. Comparisonof an interferon-y Release Assay with Tuberculin Skin Testingin HIV- infected individuals. AM J Respir Crit Care Med2007;175:737-42.
11. Saenghirunvattana S. Useful of Quantiferon G in managingsolitary pulmonary nodule of less than 3cm. Eur Respir J2011;38:2659.
12. Andrews JR, Hatherill M, Mahomed H, et al. The dynamicsof QuantiFERON-TB Gold IN-TUBE Conversion andReversion in a Cohort of South African Adolescents. Am JRespair Crit Care Med 2015;191(5):584-91.
13. Johnson JL MD, Geldenhuys H, Thiel B et al. Effects ofIsoniazid Therapy for Latent TB Infection on QauntiFERON-TBGold In-Tube responses in adults with positive TuberculinSkin Test Results in a High Incidence Area. Chest2014;145(3):612-7.
14. World Health Organization. Implementing the WHO Stop TBStrategy: A Handbook for National Tuberculosis ControlPrograms 2008. Geneva. Switzerland.
15. Saenghirunvattana S. Effect of Isoniazid prophylaxis onincidence of active tuberculosis among Thai HIV-infectedindividuals, J Med Assoc Thai 1996:79(5):285-7.
16. Centers for Disease Prevention. Severe Isoniazid AssociatedLiver Injuries among persons being treated for LatentTuberculosis Infection-United States-2004-2008. MMWRMorb Mortal Rep 2010;59(08);224-9.
17. Komiya K, Ariga H, Kurashima A, et al. Reversion rates ofQuantiFERON-TB Gold are related to pretreatmentIFN-gamma levels, J Infect 2011;63(1):48-53
18. Pettruccioli E, Vanini V, Chiacchio T et al. Analyticalevaluation of Quantiferon-Plus and Quantiferon-Gold In-Tubeassays in subjects with or without tuberculosis. Tuberculosis2017;106:38-43.