AAC Accepts, published online ahead of print on 2 June 2014 Antimicrob. Agents Chemother. doi:10.1128/AAC.02441-14 Copyright © 2014, American Society for Microbiology. All Rights Reserved.
1
Risk Factors and Outcomes of Patients with Bloodstream Infection (BSI) due to
2
Acinetobacter baumannii-calcoaceticus Complex (ABC)
3 4
Teena Chopra, MD, MPH1#, Dror Marchaim, MD2, Paul C. Johnson, MD1, Reda A.
5
Awali, MD, MPH1, Hardik Doshi, MD1, Indu Chalana, MD1, Naomi Davis, MD, MPH1,
6
Jing J. Zhao, PharmD1, Jason M. Pogue, PharmD1, Sapna Parmar1, and Keith S. Kaye,
7
MD, MPH1
8 9
Division of Infectious Diseases, Detroit Medical Center and Wayne State University,
10
Detroit, MI, USA1
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Division of Infectious Diseases, Assaf Harofeh Medical Center, Zerifin, and Sackler
12
School of Medicine, Tel-Aviv University, Tel-Aviv, Israel2
13 14
Running Head: Risk Factors of Patients with BSI due to ABC
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# Corresponding author. Mailing address: Division of Infectious Diseases, University
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Health Center, 4201 St. Antoine, Suite 2B, Detroit, MI 48201. Phone: (313) 993-6134.
18
Fax: (313) 9669898. Email: tchopra/at/med.wayne.edu
19 20 21 22 23
1
24
ABSTRACT
25
Identifying patients at risk for bloodstream infection (BSI) due to Acinetobacter
26
baumannii-calcoaceticus complex (ABC) and providing early appropriate therapy is
27
critical in improving patients’ outcomes. A retrospective matched case-control study was
28
conducted to investigate the risk factors of BSI due to ABC in patients admitted to the
29
Detroit Medical Center (DMC) between January 2006 and April 2009. Cases were
30
patients with BSI due to ABC; controls were patients not infected with ABC. Potential
31
risk factors were collected 30 days prior to ABC positive culture date for the cases and 30
32
days prior to admission for the controls. A total of 245 case-patients were matched with
33
245 control-patients. Independent risk factors associated with BSI due to ABC included
34
Charlson’s comorbidity score≥3 (OR= 2.34, p= 0.001), direct admission from other
35
health-care facilities (OR= 4.63, p< 0.0001), prior hospitalization (OR= 3.11, p< 0.0001),
36
presence of an indwelling central venous line (OR= 2.75, p= 0.011 ), receipt of total
37
parentral nutrition (OR= 21.2, p< 0.0001), prior receipt of β-lactams (OR= 3.58, p
1
Risk Factors and Outcomes of Patients with Bloodstream Infection (BSI) due to
2
Acinetobacter baumannii-calcoaceticus Complex (ABC)
3 4
Teena Chopra, MD, MPH1#, Dror Marchaim, MD2, Paul C. Johnson, MD1, Reda A.
5
Awali, MD, MPH1, Hardik Doshi, MD1, Indu Chalana, MD1, Naomi Davis, MD, MPH1,
6
Jing J. Zhao, PharmD1, Jason M. Pogue, PharmD1, Sapna Parmar1, and Keith S. Kaye,
7
MD, MPH1
8 9
Division of Infectious Diseases, Detroit Medical Center and Wayne State University,
10
Detroit, MI, USA1
11
Division of Infectious Diseases, Assaf Harofeh Medical Center, Zerifin, and Sackler
12
School of Medicine, Tel-Aviv University, Tel-Aviv, Israel2
13 14
Running Head: Risk Factors of Patients with BSI due to ABC
15 16
# Corresponding author. Mailing address: Division of Infectious Diseases, University
17
Health Center, 4201 St. Antoine, Suite 2B, Detroit, MI 48201. Phone: (313) 993-6134.
18
Fax: (313) 9669898. Email: tchopra/at/med.wayne.edu
19 20 21 22 23
1
24
ABSTRACT
25
Identifying patients at risk for bloodstream infection (BSI) due to Acinetobacter
26
baumannii-calcoaceticus complex (ABC) and providing early appropriate therapy is
27
critical in improving patients’ outcomes. A retrospective matched case-control study was
28
conducted to investigate the risk factors of BSI due to ABC in patients admitted to the
29
Detroit Medical Center (DMC) between January 2006 and April 2009. Cases were
30
patients with BSI due to ABC; controls were patients not infected with ABC. Potential
31
risk factors were collected 30 days prior to ABC positive culture date for the cases and 30
32
days prior to admission for the controls. A total of 245 case-patients were matched with
33
245 control-patients. Independent risk factors associated with BSI due to ABC included
34
Charlson’s comorbidity score≥3 (OR= 2.34, p= 0.001), direct admission from other
35
health-care facilities (OR= 4.63, p< 0.0001), prior hospitalization (OR= 3.11, p< 0.0001),
36
presence of an indwelling central venous line (OR= 2.75, p= 0.011 ), receipt of total
37
parentral nutrition (OR= 21.2, p< 0.0001), prior receipt of β-lactams (OR= 3.58, p
