The Impact of Multidrug-Resistant Acinetobacter baumannii Infection in Critically Ill Patients with or without COVID-19 Infection.

Thamer A Alenazi,Maryam S Bin Shaman, Durria M Suliman, Turkiah A Alanazi,Shoroq M Altawalbeh,Hanan Alshareef, Doha I Lahreche,Sayer Al-Azzam,Mohammad Araydah,Reema Karasneh, Faycal Rebahi, Marwah H Alharbi,Mamoon A Aldeyab

Healthcare (Basel, Switzerland)(2023)

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摘要
This is a single-center, retrospective, cohort study aimed to evaluate the clinical outcomes of multi-drug resistance in infections (MDR-AB) in intensive care unit (ICU) patients with or without a COVID-19 infection and risk factors for blood stream infection. A total of 170 patients with MDR-AB were enrolled in the study. Of these, 118 (70%) patients were admitted to the ICU due to a COVID-19 infection. Comparing the COVID-19 and non-COVID-19 groups, the use of mechanical ventilation (98.31% vs. 76.92%, = 0.000), the presence of septic shock (96.61% vs. 82.69%, = 0.002), and the use of steroid (99.15% vs. 71.15%, = 0.000) and tocilizumab therapies (33.05% vs. 0%, = 0.000) were more prevalent and statistically more significant in patients with COVID-19 infections. The average length of the ICU stay (21.2 vs. 28.33, = 0.0042) was significantly lower in patients with COVID-19 infections. Survival rate was 21.19% for the COVID-19 group and 28.85% for non-COVID-19 group with a -value = 0.0361. COVID-19 status was associated with significantly higher hazards of death (HR 1.79, CI 95% 1.02-3.15, = 0.043). Higher SOFAB (15.07 vs. 12.07, = 0.0032) and the placement of an intravascular device (97.06% vs. 89.71%, = 0.046) were significantly associated with the development of a bloodstream infection. Our study has shown that critically ill patients with an MDR-AB infection, who were admitted due to a COVID-19 infection, had a higher hazard for death compared to non-COVID-19 infected patients.
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COVID-19 infection,critically ill patients,intensive care unit,multidrug-resistant Acinetobacter baumannii
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