Association between the Antimicrobial Choice for Initial Treatment of Acinetobacter Bacteremia and the Mortality

Abstract

Gram-negative glucose-non-fermenting Acinetobacter can be isolated from the natural environment and from the skin and intestinal tract of both healthy and immunocompromised patients, and can cause blood-stream infections and pneumonia in immunocompromised patients. Although Acinetobacter strains frequently show resistance to drugs and are often resistant to the initially selected antimicrobial agents, there are lim-ited studies on the initial treatment and prognosis. In this study, we retrospectively analyzed the data of 68 cases of Acinetobacter bacteremia seen from January 2009 to July 2018 at our institution. The mean age of the patients was 69 years. The most common infections that necessitated administration of antimicrobial agents were intestinal infections (34%) and catheter infections (25%). There was no difference in the 30-day mortality between the groups with the aforementioned infections (9 (21%) vs. 6 (24%) (P=0.90)). The prognos-tic factors in Acinetobacter bacteremia do not depend on the antimicrobial selected for the initial treatment, but may be greatly influenced by underlying diseases and age. The findings suggest that choice of the appropriate treatment based on the results of culture is more important than widespread treatment in the early stage.