Risk Factors for Developing Infection Among Patients with Previous Carbapenem-Resistant Acinetobacter baumannii in Respiratory Colonization in the General Wards

Abstract

Purpose:

Carbapenem-resistant Acinetobacter baumannii (CRAB) is an opportunistic infectious agent that can cause bacterial colonization and nosocomial infection. This study aims to explore independent risk factors associated with progression from respiratory colonization to infection among CRAB-colonized patients in the general wards.

Methods:

We performed a retrospective study among 202 CRAB-colonized patients in the general wards of our hospital between January 2021 and December 2023. We employed both univariate and multivariable logistic regression models to explore factors associated with the progression from colonization to infection.

Results:

Among 202 CRAB-colonized patients, 66 experienced progression to subsequent infection and 36 died within 28 days. CRAB-colonized patients with subsequent infection had a significantly higher mortality rate (27.27% vs. 13.24%) than patients without infection (p = 0.014). After performing multivariate logistic regression analysis, CRAB-colonized patients with lower albumin (ALB) levels (OR = 0.94, p = 0.029), as well as those receiving antibiotics (OR = 2.49, p = 0.020) or glucocorticoids (OR = 2.49, p = 0.005), were at higher risk of subsequent infection. Furthermore, among patients with CRAB infection developed after colonization, the use of antifungal drugs (OR = 18.06, p = 0.002) and central venous catheter (OR = 10.73, p = 0.002) was the factors that associated with 28-day mortality.

Conclusion:

Our study analyzed CRAB colonization and infection in general medicine wards. Lower ALB levels and antibiotic/glucocorticoid use were risk factors for infection in colonized patients. Among those developing CR-CRAB infection, antifungal use and central venous catheters were associated with 28-day mortality. These findings can inform preventive and therapeutic guidelines for CRAB infections.