Nosocomial Acinetobacter baumanii and Pseudomonas aeruginosa bacteraemia: clinical characteristics and risk factor analysis compared

Abstract

In order to compare the clinical and cost outcomes for nosocomial Acinetobacter baumanii and Pseudomonas aeruginosa bacteraemia, we undertook a cross-sectional study reviewing all patients with documented nosocomial bacteraemia involving these organisms during the period 1 January 1998 to 30 April 1999 in Changhua Christian Hospital, China. Twenty three patients with documented nosocomial A. baumanii bacteraemia, and 47 patients with documented nosocomial P. aeruginosa bacteraemia during the study period formed the two study groups. The mean age was 60.7 years in the A. baumanii group, and 53.3 years in the P. aeruginosa group. The male-to-female ratio was 1:3 in the A. baumanii group, and 1:6 in the P. aeruginosa group. The severity of underlying disease was not significantly different for either group. The risk factors associated with nosocomial bacteraemia were analysed. Only arterial catheter usage showed a statistically significant difference between the A. baumanii and P. aeruginosa groups (52% vs 23%, p = 0.03). The mortality rate was 56.5% (13/23) in the A. baumanii group, and 57.4% (27/47) in the P. aeruginosa group; there was no significant difference in mortality between the groups. Infection with either organism resulted in increased cost; however, there was no significant difference between the costs incurred by each of the two study groups. Early identification of high-risk patients would facilitate the institution of prophylactic measures and reduce the impact of sequelae.