Prognostic Factors of Patients with Acinetobacter Baumannii Bacteraemia Infection in Hospital Universiti Sains Malaysia

Acinetobacter baumannii has emerged as an important and problematic human pathogen as it is the causative agent of several type of infection including bacteraemia. The research finding on the prognostic factors obtained are expected to help in management the Acinetobacter baumannii nosocomial infection and improving the survival rate. The purpose of this study are to determine the prognostic factors that influence the mortality among patients with Acinetobacter baumannii bacteraemia infection and to determine the median survival of this patients. A retrospective record review was conducted involving 130 patients of bacteraemia infected with Acinetobacter baumannii in HUSM, from 1st January 2010 to 31st December 2011. All patients who fulfilled the inclusion and exclusion criteria were included in the study. Additional follow up was done from 1st January 2012 until 31st January 2012 (1 month). All the important information on the variables interest and patients' survival status until 31st January 2012 were collected and recorded into the data collection form. Kaplan Meier estimator, simple and multiple Cox Proportional Hazard regression were performed to determine the median survival and statistical significance of the prognostic factors. A total of 67 (51.5%) patients died in this study. The overall median survival time for patient with Acinetobacter baumannii bacteraemia in this study was 40 days (95% CI: 31.33, 44.99). After adjusting for other variables, the significant prognostic factors that influenced the mortality of Acinetobacter baumannii nosocomial bacteraemia in this study were mechanical ventilation and (HR= 57.18; 95% CI: 37.79, 61.66; p-value <0.001) and antibiotic susceptibility (HR= 3.15; 95% CI: 1.69, 5.88; p-value <0.001). The median survival time for patients with Acinetobacter baumannii bacteraemia in this study was higher (40 days) compared to the previous study. Patients with Acinetobacter baumannii bacteraemia who needed mechanical ventilation and resistant to antibiotics were at higher risk death compared with those who did not need mechanical ventilation and susceptible to antibiotics. However, other potential prognostic factor such as invasive procedure, presence of neutropenia, and renal failure were not identified as the significant prognostic factor in this study.