Multidrug-Resistant Acinetobacter baumannii May Cause Patients to Develop Polymicrobial Bloodstream Infection

Qingqing Chen; Zhencang Zheng; Qingxin Shi; Huijuan Wu; Yuping Li; Cheng Zheng

doi:10.1155/2022/8368578

Multidrug-Resistant Acinetobacter baumannii May Cause Patients to Develop Polymicrobial Bloodstream Infection

Can J Infect Dis Med Microbiol. 2022 Jun 24:2022:8368578. doi: 10.1155/2022/8368578. eCollection 2022.

Authors

Qingqing Chen¹, Zhencang Zheng², Qingxin Shi³, Huijuan Wu¹, Yuping Li⁴, Cheng Zheng⁵

Affiliations

¹ Department of Critical Care Medicine, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou 318000, China.
² Health Commission of Taizhou, Taizhou 318000, Zhejiang, China.
³ Clinical Microbiology Laboratory, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou 318000, China.
⁴ Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China.
⁵ Department of Critical Care Medicine, Taizhou Municipal Hospital, Taizhou 318000, China.

Abstract

Background: The incidence of polymicrobial bloodstream infections is increasing, the clinical characteristics of polymicrobial Acinetobacter baumannii bloodstream infections (AB-BSI) are unclear, and there are no reports of polymicrobial AB-BSI in mainland China. Therefore, our objective was to identify the clinical characteristics, risk factors, and outcomes of polymicrobial AB-BSI versus monomicrobial AB-BSI.

Methods: A retrospective survey of all patients with AB-BSI from January 1, 2015, to December 31, 2019, and their clinical data were collected and analyzed by reviewing electronic medical records. All data were compared and analyzed between groups of monomicrobial and polymicrobial AB-BSI. Risk factors for polymicrobial AB-BSI were assessed using multivariable logistic regression analysis.

Results: A total of 204 patients were included, of which 39 (19.1%) were patients with polymicrobial AB-BSI. The main sources of the pathogenicity of polymicrobial Acinetobacter baumannii bloodstream infections were skin and soft tissue (38.5% vs. 16.4%, p=0.002). Resistance to piperacillin/tazobactam as an independent factor for polymicrobial AB-BSI was found in multivariate analysis. Patients with polymicrobial AB-BSI had longer hospital stays compared to those with monomicrobial AB-BSI. However, there was no significant difference in mortality between the two groups.

Conclusions: Polymicrobial AB-BSI accounted for a significant proportion among all AB-BSI, and it did not influence mortality but was related to slightly longer total hospital stays. Multidrug resistance was associated with the development of polymicrobial AB-BSI but does not directly lead to polymicrobial AB-BSI, whereas resistance to piperacillin/tazobactam was highly correlated with polymicrobial AB-BSI. Therefore, while treating A. baumannii bloodstream infections, clinicians cannot ignore the multidrug-resistant A. baumannii, especially piperacillin/tazobactam-resistant A. baumannii, which may predispose to the development of polymicrobial AB-BSI.