Differentiation Between Acinetobacter Baumannii Colonization and Infection and the Clinical Outcome Prediction by Infection in Lower Respiratory Tract

Figures & data

Figure 1 The flow chart of this study.

Table 1 Significant Univariate and Multivariate Logistic Regression Analyses of Predictors Used to Distinguish Between Infection and Colonization

Characteristics	Infection n=571(80.0%)	Colonization n=143(20.0%)	Univariate			Multivariate
			OR	95%Cl	P	OR	95%Cl	P
Gender: male	436(76.4%)	107(74.8%)	1.087	0.711–1.661	0.701
Age, y	60.1±17.55	56.62±18.04	1.011	1.001–1.021	0.036	1.011	1.000–1.022	0.047
Smoke	166(29.1%)	33(23.1%)	1.366	0.89–2.098	0.154
ICU admission	243(42.6%)	33(23.1%)	2.47	1.618–3.769	<0.001	1.091	0.521–2.284	0.818
Total number of inpatient departments	1.68±0.77	1.36±0.61	2.006	1.478–2.724	<0.001	1.763	1.053–2.950	0.031
Charlson score	2.61±1.64	2.39±1.58	1.089	0.969–1.224	0.152
WBC, median(interquartile range), *10e9/L	9.05(7.23)	7.695(5.155)	1.042	1.009–1.077	0.012	1.004	0.972–1.037	0.82
N, median(interquartile range), *10e9/L	7.05(6.06)	5.43(4.05)	1.102	1.051–1.157	<0.001	1.068	1.006–1.134	0.031
L<0.8*10e9/L	325(56.9%)	91(63.6%)	0.755	0.517–1.013	0.146
NLR ratio, median(interquartile range)	11.77(36.47)	10.91(27.96)	1.002	0.999–1.004	0.146
BUN/ALB, median(interquartile range)	0.218(0.229)	0.182(0.164)	3.109	1.228–7.871	0.017	1.011	0.435–2.353	0.979
PCT, median(interquartile range), ng/mL	0.28(0.906)	0.117(0.34)	1.019	0.984–1.057	0.291
CRP, median(interquartile range), mg/L	32.5(67.96)	15.5(36.45)	1.01	1.006–1.015	<0.001	1.007	1.002–1.012	0.005
MDR pathogens	389(68.1%)	89(62.2%)	1.297	0.886–1.899	0.181

Notes: Data were presented by median (interquartile range), numbers (percentage), or mean ± standard deviation (x±s) (continuous). Continuous variables were compared using Student’s t-test or Mann–Whitney U-test and categorical variables using Pearson’s chi-square or Fisher’s exact probability test. P-value<0.05 is considered significant.

Abbreviations: ICU admission, intensive care unit admission; WBC, white blood cell; N, absolute value of neutrophil; L, absolute value of lymphocyte; NLR ratio, Neutrophils/lymphocytes ratio; BUN/ALB, blood urea nitrogen/albumin; PCT, procalcitonin; CRP, C-reactive protein; MDR pathogens, multidrug resistant pathogens.

Figure 2 Comparison of different receiver-operating characteristics curves for predicting infection or colonization model.

Table 2 Significant Univariate and Multivariate Logistic Regression Analyses of Predictors for Hospital-Acquired Pneumonia in-Hospital Mortality

Characteristics	Related mortality n=117	Survival n=454	Univariate			Multivariate
			OR	95%Cl	P	OR	95%Cl	P
Gender: male	93(79.5%)	343(75.6%)	1.254	0.763–2.062	0.372
Age, y	57.20±17.98	60.85±17.38	0.988	0.977–1.000	0.046	0.974	0.960–0.988	<0.001
Smoke	30(25.6%)	136(30.0%)	0.806	0.508–1.279	0.36
ICU admission	65(55.6%)	178(39.2%)	1.938	1.286–2.922	0.002	1.215	0.566–2.607	0.617
Total number of inpatient departments	1.80±0.83	1.64±0.75	1.298	1.006–1.674	0.045	0.897	0.551–1.462	0.664
Charlson score	3.34±1.42	2.42±1.64	1.391	1.229–1.574	<0.001	1.352	1.172–1.561	<0.001
WBC, median(interquartile range), *10e9/L	10.97(6.48)	8.79(7.13)	1.019	0.995–1.043	0.123
N, median(interquartile range), *10e9/L	9.16(6.11)	6.64(5.47)	1.073	1.034–1.113	<0.001	1.013	0.970–1.057	0.561
L<0.8*10e9/L	75(64.1%)	250(55.1%))	1.457	0.957–2.219	0.079
NLR ratio, median(interquartile range)	19.23(58.05)	10.63(29.86)	1.003	1.002–1.005	<0.001	1.002	1.001–1.004	0.008
BUN/ALB, median(interquartile range)	0.35(0.36)	0.19(0.20)	10.233	4.799–21.823	<0.001	5.783	2.543–13.151	<0.001
PCT, median(interquartile range), ng/mL	0.95(3.43)	0.20(0.53)	1.042	1.013–1.073	0.005	1.008	0.984–1.032	0.52
CRP, median(interquartile range), mg/L	69.0(93.9)	27.5(56.13)	1.011	1.007–1.014	<0.001	1.006	1.002–1.010	0.004
MDR pathogens	98(83.8%)	291(64.1%)	2.889	1.705–4.896	<0.001	1.900	1.043–3.463	0.036
CPIS≥6	105(89.7%)	303(66.7%)	4.361	2.326–8.174	<0.001	2.352	1.115–4.959	0.025

Notes: Data were presented by median (interquartile range), numbers (percentage), or mean ± standard deviation (x±s) (continuous). Continuous variables were compared using Student’s t-test or Mann–Whitney U-test and categorical variables using Pearson’s chi-square or Fisher’s exact probability test. P-value<0.05 is considered significant.

Abbreviations: ICU, admission intensive care unit admission; WBC, white blood cell; N, absolute value of neutrophil; L, absolute value of lymphocyte; NLR ratio, Neutrophils/lymphocytes ratio; BUN/ALB, blood urea nitrogen/albumin; PCT, procalcitonin; CRP, C-reactive protein; MDR pathogens, multidrug resistant pathogens; CPIS, Clinical Pulmonary for Infection Score.

Table 3 The Drug Resistance of a.baumannii Infection Group of Hospital-Acquired Pneumonia

Antibiotic	Cases	Percent
CFZ	571	100.00
CTR	564	98.77
CXM	410	71.80
IMP	369	64.62
CIP	368	64.45
MER	364	63.75
SAM	362	63.40
CFM	360	63.05
CEF	359	62.87
CTX	359	62.87
LEV	358	62.70
GEN	353	61.82
AMC	340	59.54
SXT	300	52.54
TAZ	264	46.23
TGC	2	0.35

Abbreviations: HAP, hospital-acquired pneumonia; CFZ, cefazolin; CTR, ceftriaxone; CXM, cefuroxime; IMP, imipenem; CIP, ciprofloxacin; MER, meropenem; SAM, ampicillin sulbactam; CFM, cefepime; CEF, ceftazidime; CTX, cefotaxime; LEV, levofloxacin; GEN, gentamicin; AMC, amikacin; SXT, Cotrimoxazole; TAZ, piperacillin/tazobactam; TGC, tigecycline.

Figure 3 Analysis of receiver-operating characteristics curve for predicting mortality model.