Division of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital, No. 201, Section 2, Shih-Pai Road, Taipei 11217, Taiwan.
Infection. 2012 Feb;40(1):19-26. doi: 10.1007/s15010-011-0187-4. Epub 2011 Sep 2.
Acinetobacter baumannii, Acinetobacter genomic species 3 (AGS 3), and Acinetobacter genomic species sensu Tjernberg and Ursing (AGS 13TU) are phenotypically indistinguishable and are often reported together as the A. baumannii complex (ABC). Few studies have investigated the difference in outcome caused by these different species, and all involved heterogeneous groups of patients. This study aimed to delineate whether there are differences in the clinical characteristics and outcome among patients with solid tumors and bacteremia caused by A. baumannii or two other non-baumannii ABC species (AGS 3 plus AGS 13TU).
Patients with solid tumors and ABC bacteremia over a period of 5 years in a medical center were identified. The patient data were retrospectively reviewed and analyzed.
We identified 103 patients with ABC bacteremia during the study period. Bacteremia was due to A. baumannii in 30 patients, AGS 3 in 24 patients, and AGS 13TU in 49 patients. Among the 103 patients with ABC bacteremia, recent stay in the intensive care unit (ICU) (p = 0.008) was independently associated with the acquisition of A. baumannii bacteremia. Multivariate analysis revealed that bacteremia caused by A. baumannii (hazard ratio [HR] 2.990, 95% confidence interval [CI], 1.021-8.752, p = 0.046) and Acute Physiology and Chronic Health Evaluation (APACHE) II score ≥21 (HR 4.623, 95% CI 1.348-15.859, p = 0.015) were independent factors associated with 14-day mortality.
Infection with A. baumannii and a high APACHE II score (≥21) might be associated with poor outcome in patients with solid tumors and ABC bacteremia.
鲍曼不动杆菌、不动杆菌基因组种 3（AGS 3）和不动杆菌基因组种 13TU（AGS 13TU）在表型上无法区分，并且经常被归为鲍曼不动杆菌复合体（ABC）一起报告。很少有研究调查这些不同物种引起的结果差异，而且所有研究都涉及异质的患者群体。本研究旨在探讨实体瘤患者和由鲍曼不动杆菌或另外两种非鲍曼不动杆菌 ABC 种（AGS 3 加 AGS 13TU）引起菌血症的患者在临床特征和结局方面是否存在差异。
在一家医疗中心的 5 年期间，确定患有实体瘤和 ABC 菌血症的患者。回顾性回顾和分析患者数据。
在研究期间，我们确定了 103 例 ABC 菌血症患者。30 例患者血培养为鲍曼不动杆菌，24 例为 AGS 3，49 例为 AGS 13TU。在 103 例 ABC 菌血症患者中，近期入住重症监护病房（ICU）（p=0.008）与获得鲍曼不动杆菌菌血症独立相关。多变量分析显示，鲍曼不动杆菌引起的菌血症（危险比 [HR]2.990，95%置信区间 [CI]1.021-8.752，p=0.046）和急性生理学和慢性健康评估（APACHE）II 评分≥21（HR4.623，95%CI1.348-15.859，p=0.015）是与 14 天死亡率相关的独立因素。
感染鲍曼不动杆菌和高 APACHE II 评分（≥21）可能与实体瘤和 ABC 菌血症患者的不良结局相关。
