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Open Access 01-12-2023 | Carbapenem Antibiotic | Research

Acinetobacter spp. bloodstream infection in hematological patients: a 10-year single-center study

Authors: Jia Li, Xiaomeng Feng, Jieru Wang, Qingsong Lin, Yizhou Zheng, Fengkui Zhang, Yingchang Mi, Xiaofan Zhu, Erlie Jiang, Zhijian Xiao, Jianxiang Wang, Sizhou Feng

Published in: BMC Infectious Diseases | Issue 1/2023

Abstract

Purpose

This study investigated the clinical and antimicrobial characteristics of Acinetobacter spp. bloodstream infection (BSI) in hematological patients. Risk factors for 30-day mortality and carbapenem-resistant Acinetobacter spp. (CRA) BSI acquisition were also identified.

Methods

We reviewed forty hematological patients with Acinetobacter spp. BSI in a large Chinese blood disease hospital between 2013 and 2022. The remaining CRA isolates were subjected to whole-genome sequencing.

Results

The 30-day mortality rate was high at 35%. Hematological patients with Acinetobacter spp. BSI often presented with severe conditions and co-infections at multiple sites. All strains were colistin-susceptible and 40.0% were CR. Multivariate analysis identified several risk factors associated with CRA BSI acquisition, including previous exposure to carbapenems within 30 days and CRA colonization. Very severe aplastic anaemia, tetracycline-resistant Acinetobacter spp. BSI, and unresolved neutropenia after infection were closely associated with 30-day mortality. Non-survivors often presented with higher median PCT and CRP levels and severe complications, such as intracranial infection, cardiac dysfunction, respiratory failure, and severe sepsis or septic shock. Our study also identified inappropriate empirical antibiotic therapy as an independent predictor of 30-day mortality (OR: 11.234, 95% CI: 1.261–20.086, P = 0.030). This study was the first to report A. oleivorans as a human pathogen, and to identify its unique oxacillinase, OXA-325.

Conclusion

An environment-originated non-pathogenic species can become pathogenic when the body’s immunity is compromised. Our results also highlighted the importance of improving neutropenia after infection, treating severe organ dysfunction, and administering appropriate empirical antibiotic therapy to reduce mortality in this patient population.

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Title: Acinetobacter spp. bloodstream infection in hematological patients: a 10-year single-center study
Authors: Jia Li
Xiaomeng Feng
Jieru Wang
Qingsong Lin
Yizhou Zheng
Fengkui Zhang
Yingchang Mi
Xiaofan Zhu
Erlie Jiang
Zhijian Xiao
Jianxiang Wang
Sizhou Feng
Publication date: 01-12-2023
Publisher: BioMed Central
Keywords: Carbapenem Antibiotic
Tetracyclines
Antibiotic
Neutropenia
Published in: BMC Infectious Diseases / Issue 1/2023
Electronic ISSN: 1471-2334
DOI: https://doi.org/10.1186/s12879-023-08789-6

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