Clinical Characteristics and Prognosis Analysis of Acinetobacter baumannii Bloodstream Infection Based on Propensity Matching

Figures & data

Figure 1 Study design of Acinetobacter baumannii BSI patients.

Table 1 Demographic and Clinical Characteristics of 398 Patients with Acinetobacter baumannii BSI

Characteristics	Total, n=398
Demographics
Gender(male,%)	264(66.3)
Age(Years)	53.0±15.9
Hospital stay	20.0[11.0,35.0]
ICU stay	10.0[4.0,19.3]
Any comorbidity, n(%)	371(93.2)
Diabetes	75(18.8)
Hypertension	97(24.4)
Cardiovascular disease	96(24.1)
Cardiopulmonary Resuscitation	80(20.1)
Malignancy	42(10.6)
Renal failure	82(20.6)
Pulmonary infection	290(72.9)
Respiratory failure	195(49.0)
Invasive procedures	328(82.4)
Mechanical ventilation	237(59.5)
Surgery	207(52.0)
Condition prior to infection onset
Hospital stay	11.0[6.0,19.0]
ICU stay	6.0[3.0,12.0]
Inpatient department
ICU	316(79.4)
N-ICU	82(20.6)
Resistance
Drug resistance (S-AB, %)	36(9.0)
Drug resistance (MDR-AB, %	145(36.4)
Drug resistance (XDR-AB, %)	207(52.0)
Drug resistance (PDR-AB, %)	10(2.5)
CRAB (%)	345(86.7)
Laboratory index
White blood	9.1[5.2,13.9]
PCT	2.4[0.6,11.9]
CRP	103.2[34.9,118.7]
Lac	2.2[1.2,4.1]
Severity
Septic shock	229(57.5)
GCS	9.0[4.0,14.0]
APACHE II	20.1±9.6
SOFA	10.0±5.4

Abbreviations: ICU, Intensive: Intensive Care Unit; N-ICU, non- Intensive: Intensive Care Unit; S-AB, Sensitive-Acinetobacter baumannii; MDR-AB, Multidrug resistance- Acinetobacter baumannii; XDR-AB, Extensive drug-resistance-Acinetobacter baumannii; PDR-AB, pandrug re-sistance-Acinetobacter baumannii; CRAB, carbapenem-resistant Acinetobacter baumannii; PCT, Procalcitonin; CRP, C-Reactive Protein; lac, Lactic Acid.

Table 2 Univariate Logistic Regression Analysis for Risk Factors of 28-Day Mortality for Patients with Acinetobacter baumannii BSI

Characteristics	Survival (n=150)	Death(n=248)	OR(95% CI)	P
Demographics
Gender(male,%)	99(66.0)	165(66.5)	0.976(0.636,1.499)	0.913
Age(Years)	51.5±15.0	53.9±16.4	1.009(0.997,1.022)	0.148
Hospital stay	31.0[19.75,47.5]	15.0[9.0,26.0]	0.965(0.953,0.976)	<0.001
ICU stay	9.0[0.0,24.25]	10.0[6.0,18.0]	0.995(0.982,1.008)	0.422
Any comorbidity, n(%)	140(93.3)	231(93.1)	0.991(0.636,1.502)	0.942
Diabetes	30(20.0)	45(18.1)	0.887(0.530,1.483)	0.647
Hypertension	38(25.3)	59(23.8)	0.920(0.575,1.472)	0.728
Cardiovascular disease	31(20.7)	65(26.2)	1.363(0.839,2.217)	0.211
Cardiopulmonary Resuscitation	2(1.3)	78(31.5)	33.953(8.201,140.573)	<0.001
Malignancy	15(10.0)	27(10.9)	1.100(0.565,2.141)	0.78
Renal failure	11(7.3)	71(28.6)	5.069(2.586,9.934)	<0.001
Pulmonary infection	81(54.0)	209(84.3)	4.565(2.856,7.297)	<0.001
Respiratory failure	32(21.3)	163(65.7)	7.071(4.417,11.320)	<0.001
Invasive procedures	104(69.3)	224(90.3)	4.128(2.392,7.124)	<0.001
Mechanical ventilation	89(59.3)	148(59.7)	8.538(5.366,13.586)	<0.001
Surgery	89(59.3)	118(47.6)	0.622(0.413,0.938)	0.023
Condition prior to infection onset
Hospital stay	12.0[8.0,19.25]	10.0[6.0,17.8]	0.989(0.973,1.006)	0.209
ICU stay	4.5[0.0,12.0]	7.0[4.0,12.0]	1.021(0.996,1.047)	0.101
Inpatient department			0.171(0.102,0.288)	<0.001
ICU	89(59.3)	227(91.5)
N-ICU	61(40.7)	21(8.5)
Resistance
Drug resistance (S-AB, %)	32(21.3)	4(1.6)	0.060(0.021,0.175)	<0.001
Drug resistance (MDR-AB, %	50(33.3)	95(38.3)	1.242(0.812,1.900)	0.318
Drug resistance (XDR-AB, %)	64(42.7)	143(57.7)	1.830(1.214,2.758)	0.004
Drug resistance (PDR-AB, %)	4(2.7)	6(2.4)	0.905(0.251,3.260)	0.879
CRAB (%)	105(70.0)	240(96.8)	12.857(5.857,28.222)	<0.001
Laboratory index
White blood	8.9[6.0,13.5]	9.3[4.5,14.6]	0.996(0.970,1.023)	0.779
PCT	1.5[0.3,5.5]	3.5[0.8,14.9]	1.030(1.014,1.047)	<0.001
CRP	78.6[23.1,104.2]	104.2[44.9,155.0]	1.006(1.003,1.009)	<0.001
Lac	1.6[0.9,4.1]	2.8[1.5,6.1]	1.281(1.161,1.413)	<0.001
Severity
Septic shock	41(27.3)	188(75.8)	1.778(1.159,2.728)	0.008
GCS	12.0[9.0,15.0]	6.0[3.0,12.0]	0.833(0.793,0.875)	<0.001
APACHE II	13.6±6.9	23.4±10.6	1.118(1.084,1.152)	<0.001
SOFA	6.1±3.9	12.3±4.8	1.413(1.314,1.519)	<0.001

Abbreviations: ICU, Intensive: Intensive Care Unit; N-ICU, non- Intensive: Intensive Care Unit; S-AB, Sensitive-Acinetobacter baumannii; MDR-AB, Multidrug resistance- Acinetobacter baumannii; XDR-AB, Extensive drug-resistance-Acinetobacter baumannii; PDR-AB, pandrug re-sistance-Acinetobacter baumannii; CRAB, carbapenem-resistant Acinetobacter baumannii; PCT, Procalcitonin; CRP, C-Reactive Protein; lac, Lactic Acid.

Table 3 Multivariate Logistic Regression Analysis for Risk Factors of 28-Day Mortality for Patients with Acinetobacter baumannii BSI

Characteristics	OR(95% CI)	P value
Hospital stay	0.960(0.942,0.978)	<0.001
Cardiopulmonary Resuscitation	6.389(1.308,31.215)	0.022
Renal failure	3.427(1.146,10.251)	0.028
APACHE II	1.076(1.005,1.151)	0.034

Table 4 Univariate Logistic Regression Analysis for Risk Factors of 28-Day Mortality for Patients with Acinetobacter baumannii BSI After Propensity Score Matching

Characteristics	Survival, n=63	Death, n=63	OR (95% CI)	P
Demographics
Gender(male,%)	99(66.0)	41(65.1)	1.250(0.585,2.670)	0.565
Age(Years)	52.87±14.00	53.16±15.77	1.001(0.978,1.025)	0.913
Hospital stay	35.0[22.0,44.0]	24.0[14.0,34.0]	0.985(0.969,1.002)	0.089
ICU stay	16.0[5.0,28.0]	14.0[6.0,27.0]	1.004(0.984,1.024)	0.7
Any comorbidity, n(%)	60(95.2)	58(92.1)	0.500(0.092,2.730)	0.423
Diabetes	11(17.5)	14(22.2)	1.429(0.544,3.753)	0.469
Hypertension	15(23.8)	14(22.2)	0.923(0.421,2.023)	0.842
Cardiovascular disease	9(14.3)	16(25.4)	1.875(0.795,4.422)	0.151
Cardiopulmonary Resuscitation	2(3.2)	7(11.1)	3.5(0.727,16.848)	0.118
Malignancy	4(6.3)	7(11.1)	1.750(0.512,5.978)	0.372
Renal failure	4(6.3)	9(14.3)	3.5(0.727,16.848)	0.118
Pulmonary infection	45(71.4)	48(76.2)	1.333(0.562,3.164)	0.514
Respiratory failure	22(34.9)	25(39.7)	1.250(0.585,2.670)	0.565
Invasive procedures	52(82.5)	50(79.4)	0.800(0.316,2.027)	0.638
Mechanical ventilation	21(33.3)	41(65.1)	5.000(1.914,13.061)	0.001
Surgery	41(65.1)	35(55.6)	0.647(0.303,1.381)	0.261
Condition prior to infection onset
Hospital stay	12.0[8.0,20.0]	11.0[7.0,20.0]	0.989(0.973,1.006)	0.803
ICU stay	9.0[3.0,16.0]	8.0[4.0,13.0]	1.021(0.996,1.047)	0.587
Inpatient department			0.700(0.266,1.839)	0.469
ICU	49(77.8)	52(82.5)
N-ICU	14(22.2)	11(17.5)
Resistance
Drug resistance (S-AB, %)	4(6.3)	2(3.2)	0.500(0.092,2.730)	0.423
Drug resistance (MDR-AB, %	50(33.3)	95(38.3)	1.242(0.812,1.900)	0.318
Drug resistance (XDR-AB, %)	39(61.9)	37(58.7)	0.875(0.427,1.793)	0.715
Drug resistance (PDR-AB, %)	4(2.7)	6(2.4)	0.905(0.251,3.260)	0.879
CRAB (%)	58(92.1)	59(93.7)	1.250(0.336,4.655)	0.739
Laboratory index
White blood	10.1[6.64,13.9]	9.7[6.7,13.2]	0.958(0.894,1.026)	0.218
PCT	0.77[0.23,3.01]	1.79[0.54,6.29]	1.022(0.986,1.059)	0.237
CRP	99.2[38.9,104.21]	104.21[44.47,109.14]	1.003(0.997,1.008)	0.354
Lac	1.5[1.0,2.3]	1.9[1.2,3.2]	1.122(0.919,1.368)	0.258
Severity
Septic shock	38(60.3)	48(76.2)	2.429(1.007,5.856)	0.048
GCS	12.0[7.0,14.0]	10.0[5.0,15.0]	0.948(0.870,1.034)	0.228
APACHE II	16.93±6.20	18.67±6.91	1.051(0.988,1.118)	0.112
SOFA	6.63±3.79	8.27±3.99	1.266(1.084,1.479)	0.003

Abbreviations: ICU, Intensive: Intensive Care Unit; N-ICU, non- Intensive: Intensive Care Unit; S-AB, Sensitive-Acinetobacter baumannii; MDR-AB, Multidrug resistance- Acinetobacter baumannii; XDR-AB, Extensive drug-resistance-Acinetobacter baumannii; PDR-AB, pandrug resistance-Acinetobacter baumannii; CRAB, carbapenem-resistant Acinetobacter baumannii; PCT, Procalcitonin; CRP, C-Reactive Protein; lac, Lactic Acid.

Table 5 Multivariate Logistic Regression Analysis for Risk Factors of 28-Day Mortality for Patients with Acinetobacter baumannii BSI After Propensity Scoring Match

Characteristics	OR(95% CI)	P value
Septic shock	2.098(0.767,5.744)	0.015
Mechanical ventilation	4.027(1.444,11.229)	0.008
SOFA	1.197(1.015,1.412)	0.032

Table 6 Comparison of Patients with Acinetobacter baumannii BSI Treated with Appropriate Empirical Antibiotic Therapy and Inappropriate Empirical Antibiotic Therapy Before and After Propensity Scoring Match

Empirical Antibiotic Therapy	Before PSM				After PSM
	Survival, n=150	Death, n=248	OR(95% CI)	P-value	Survival, n=63	Death, n=63	OR (95% CI)	P-value
Appropriate empirical antibiotic therapy	90(60.0%)	133(53.6%)	1.297(0.860,1.956)	0.215	38(60.3%)	24(38.1%)	2.556(1.183,5.523)	0.017
Inappropriate empirical antibiotic therapy	60(40.0%)	115(46.4%)			25(39.7%)	39(61.9%)