J Korean Med Sci.  2011 Mar;26(3):325-331. 10.3346/jkms.2011.26.3.325.

The Outcomes of Using Colistin for Treating Multidrug Resistant Acinetobacter Species Bloodstream Infections

• Lim SK
• Lee SO
• Choi SH
• Choi JP
• Kim SH
• Jeong JY
• Choi SH
• Woo JH
• Kim YS

• KMID: 2157867
• DOI: http://doi.org/10.3346/jkms.2011.26.3.325

Abstract

Despite the identification of Acinetobacter baumannii isolates that demonstrate susceptibility to only colistin, this antimicrobial agent was not available in Korea until 2006. The present study examined the outcomes of patients with multidrug resistant (MDR) Acinetobacter species bloodstream infection and who were treated with or without colistin as part of their regimen. The colistin group was given colistin as part of therapy once colistin became available in 2006. The non-colistin group was derived from the patients who were treated with other antimicrobial regimens before 2006. Mortality within 30 days of the onset of bacteremia occurred for 11 of 31 patients in the colistin group and for 15 of 39 patients in the non-colistin group (35.5% vs 38.5%, respectively, P = 0.80). Renal dysfunction developed in 50.0% of the 20 evaluable patients in the colistin group, but in 28.6% of the 35 evaluable patients in the non-colistin group (P = 0.11). On multivariate analysis, only an Acute Physiological and Chronic Health Evaluation II score > or = 21 was associated with mortality at 30 days. This result suggests that administering colistin, although it is the sole microbiologically appropriate agent, does not influence the 30 day mortality of patients with a MDR Acinetobacter spp. bloodstream infection.

Keyword

Acinetobacter; Colistin; Bacteremia; Drug Resistance, Multiple

MeSH Terms

APACHE
Acinetobacter/*drug effects/isolation & purification
Acinetobacter Infections/*drug therapy/mortality
Adolescent
Adult
Aged
Aged, 80 and over
Anti-Bacterial Agents/*therapeutic use
Bacteremia/*drug therapy/mortality
Child
Colistin/administration & dosage/*therapeutic use
Drug Resistance, Multiple, Bacterial/*drug effects
Female
Humans
Male
Middle Aged
Republic of Korea
Retrospective Studies
Risk
Treatment Outcome

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