Division of Infectious Diseases, Department of Internal Medicine, MacKay Memorial Hospital, Taipei, Taiwan; Department of Medicine, MacKay Medical College, New Taipei City, Taiwan; MacKay College of Medicine, Nursing and Management, Taipei, Taiwan; Infection Control Committee, MacKay Memorial Hospital, Taipei, Taiwan; Department of Medical Research, MacKay Memorial Hospital, Taipei, Taiwan.
Division of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
J Microbiol Immunol Infect. 2019 Dec;52(6):956-965. doi: 10.1016/j.jmii.2018.03.001. Epub 2018 Apr 25.
Clinical characteristics and risk factors for mortality of Acinetobacter bacteremia in cirrhotic patients have not been investigated.
Acinetobacter bacteremia cases from four medical centers were collected from 2009 to 2014, to compare between patients with and without liver cirrhosis. Risk factors for mortality of Acinetobacter bacteremia among cirrhotic patients were identified using multivariate logistic regression.
Among the patients with Acinetobacter bacteremia, 72 had liver cirrhosis and 816 had not. Patients with cirrhosis were younger (57.5 [50-71] vs. 72 [50.25-71], p < 0.001), had more solid tumor (51.4% vs. 31.4%, p = 0.001), lower Acute Physiology and Chronic Health Evaluation II (APACHE II) scores (17 [12-24] vs. 20 [13-28], p = 0.012), less sourced from pneumonia (19.4% vs. 35.8%, p = 0.008), and less caused by Acinetobacterbaumannii (33.3% vs. 50.6%, p = 0.007) than those without. After matching for age, sex, and causative pathogens, the 30-day mortality (34.7% vs. 29.2%, p = 0.592) and APACHE II scores (17 vs. 17, p = 0.769) were not significant. APACHE II score (odds ratio [OR], 1.146; 95% confidence interval [CI], 1.035-1.268; p = 0.009), bacteremia caused by A. baumannii (OR, 20.501; 95% CI, 2.301-182.649; p = 0.007), and solid tumor (OR, 18.073; 95% CI, 1.938-168.504; p = 0.011) were independent risk factors for 30-day mortality of cirrhotic patients with Acinetobacter bacteremia.
Even though cirrhotic patients with Acinetobacter bacteremia were younger and had lower APACHE II scores than non-cirrhotic patients, the mortality rates were insignificantly different between the two groups.
尚未研究肝硬化患者中不动杆菌菌血症的临床特征和死亡危险因素。
2009 年至 2014 年，从四个医疗中心收集了不动杆菌菌血症病例，以比较有和没有肝硬化的患者。使用多变量逻辑回归确定肝硬化患者中不动杆菌菌血症死亡的危险因素。
在不动杆菌菌血症患者中，72 例有肝硬化，816 例无肝硬化。肝硬化患者较年轻（57.5 [50-71] 岁 vs. 72 [50.25-71] 岁，p < 0.001），更易患有实体瘤（51.4% vs. 31.4%，p = 0.001），急性生理学和慢性健康评估 II 评分（APACHE II）较低（17 [12-24] 分 vs. 20 [13-28] 分，p = 0.012），肺部来源较少（19.4% vs. 35.8%，p = 0.008），鲍曼不动杆菌引起的感染较少（33.3% vs. 50.6%，p = 0.007）。在年龄、性别和病原体匹配后，30 天死亡率（34.7% vs. 29.2%，p = 0.592）和 APACHE II 评分（17 分 vs. 17 分，p = 0.769）无显著差异。APACHE II 评分（比值比 [OR]，1.146；95%置信区间 [CI]，1.035-1.268；p = 0.009）、鲍曼不动杆菌引起的菌血症（OR，20.501；95%CI，2.301-182.649；p = 0.007）和实体瘤（OR，18.073；95%CI，1.938-168.504；p = 0.011）是肝硬化患者发生不动杆菌菌血症 30 天死亡的独立危险因素。
尽管肝硬化合并不动杆菌菌血症的患者比非肝硬化患者年轻，且 APACHE II 评分较低，但两组患者的死亡率无显著差异。
