1261. Early Administration of Colistin Might Improve The Outcome of Carbapenem Resistant Acinetobacter baumannii Bacteremic Pneumonia 
Session: Poster Abstract Session: Clinical Infectious Diseases: Respiratory Infections
Friday, October 28, 2016
Room: Poster Hall
Posters
  • 2016_IDSA_LEJ.pdf (162.8 kB)
  • Background: Carbapenem resistant Acinetobacter baumannii (CRAB) has become leading pathogen causing nosocomial pneumonia in critically ill patients. This study aimed to describe severe infection with CRAB bacteremic pneumonia, as well as to investigate risk factors for mortality.

    Methods: All patients aged ≥18 years with a CRAB-bacteremic pneumonia were enrolled retrospectively between Apr 2012 and Mar 2015 at five teaching hospitals in South Korea. Appropriate therapy was defined as having been treated for > 24 h with Colistimethate sodium (Colistin) including Colistin based combination within 5 days of the onset of bacteremia.

    Results: During study period, 148 patients with CRAB bacteremic pneumonia were enrolled. Among them, 131 (88.5%) CRAB bacteremic pneumonia occurred in ICU, of whom 112 (75.7%) were ventilator associated pneumonia. Forty six (31.1%) patients received appropriate therapy. There was no difference in the baseline characteristics between appropriate therapy group and inappropriate therapy group (Table). However, 2-day and 5-day mortality was higher in patients with inappropriate therapy group. The 30-day mortality rates were 71.6%. In the multivariate analysis using Cox-regression analysis method, McCabe Jackson criteria (HR 1.98, 95% CI 1.22 – 2.96, p <0.001), chronic lung disease (HR 1.66, 95% CI 1.50 – 2.61, p = 0.02), APACHE II score >12 (HR 2.32, 95% CI 1.42 – 3.81, p = 0.001), and inappropriate therapy (HR 1.90, 95% CI 1.22 – 2.96, p = 0.005) were found to be associated with 30-day mortality.

    Conclusion: The mortality rate of CRAB bacteremic pneumonia was extremely high. Early administration of colistin may alter the outcome of patients with CRAB bactemic pneumonia. 

    Eun Jung Lee, MD1, Seong Yeon Park, MD2, Tark Kim, MD3, Shi Nae Yu, MD4, Ki-Ho Park, MD5, Mi Suk Lee, MD, PhD5, Min Hyok Jeon, MD6, Eun Ju Choo, MD7 and Tae Hyong Kim, MD, PhD8, (1)Infectious Diseases, SoonChunHyang University Hospital, Seoul, South Korea, (2)Internal Medicine, Dongguk University Ilsan Hospital, Goyang, Korea, The Republic of, (3)Infectious Diseases, SoonChunHyang University Bucheon Hospital, Bucheon, Korea, The Republic of, (4)Department of Internal Medicine, Soon Chun Hyang University Seoul Hospital, Seoul, South Korea, (5)Division of Infectious Diseases, Department of Internal Medicine, Kyung Hee University Hospital, Seoul, South Korea, (6)Division of Infectious Diseases, Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Cheonan, South Korea, (7)Division of Infectious Diseases, SoonChunHyang University Hospital, Bucheon, South Korea, (8)Division of Infectious Diseases, Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Seoul, South Korea

    Disclosures:

    E. J. Lee, None

    S. Y. Park, None

    T. Kim, None

    S. N. Yu, None

    K. H. Park, None

    M. S. Lee, None

    M. H. Jeon, None

    E. J. Choo, None

    T. H. Kim, None

    Findings in the abstracts are embargoed until 12:01 a.m. CDT, Wednesday Oct. 26th with the exception of research findings presented at the IDWeek press conferences.