Predictors of mortality and therapeutic efficacy in carbapenem-resistant Acinetobacter baumannii bacteremia. in The Journal of infection / J Infect. 2026 May;92(5):106742. doi: 10.1016/j.jinf.2026.106742. Epub 2026 Mar 31.

2026
AOU Alessandria

Tipo pubblicazione

Observational Study

Autori/Collaboratori (55)Vedi tutti...

Russo A
Department of Medical and Surgical Sciences, 'Magna Graecia' University of Catanzaro, Catanzaro, Italy; Infectious and Tropical Disease Unit, "Renato Dulbecco" Hospital, Catanzaro, Italy. Electronic address: a.russo@unicz.it.
Gullì SP
Department of Medical and Surgical Sciences, 'Magna Graecia' University of Catanzaro, Catanzaro, Italy.
Vena A
Infectious and Tropical Disease Unit, "San Martino" University of Genoa, Genova, Italy.

et alii...

Abstract

OBJECTIVES: Bacteremia caused by carbapenem-resistant Acinetobacter baumannii (CRAB) is associated with high morbidity and mortality. The primary objective was to identify clinical and therapeutic factors associated with 14- and 30-day mortality following infection onset. METHODS: This was a prospective, observational, multicenter study conducted across 52 Italian centers. Over an 18-month period, adult hospitalized patients with CRAB bacteremia were enrolled. RESULTS: Among 398 patients with CRAB bacteremia, sources were mainly CVC-related or primary, with 14- and 30-day mortality rates of 22% and 27% respectively. Cox regression analysis identified male sex (p=0.006), and chronic kidney disease (p=0.016) as independent predictors of 14-day mortality, while colistin-containing regimen (p=0.014), and cefiderocol-containing-regimen (p<0.001) were associated with 14-day survival; male sex (p=0.027), septic shock (p=0.018), previous colonization by A. baumannii (p<0.001), and tigecycline-containing regimen (p=0.021) were independent predictors of 30-day mortality, while cefiderocol-containing-regimen (p<0.001) was associated with 30-day survival. Propensity score matching revealed that cefiderocol was significantly associated with 14-day survival and clinical success. The combination of cefiderocol plus Fosfomycin was also significantly associated with clinical success. CONCLUSION: Our findings highlight key clinical and therapeutic determinants of mortality and survival in patients with CRAB bacteraemia, providing valuable insights for improving the management of this challenging infection.

Accesso banca dati bibliografica

PMID : 41933556

DOI : 10.1016/j.jinf.2026.106742

Keywords

Acinetobacter baumannii/drug effects; Female; Male; Humans; Acinetobacter Infections/drug therapy/mortality/microbiology; Aged; Carbapenems/pharmacology/therapeutic use; Anti-Bacterial Agents/therapeutic use/pharmacology; Prospective Studies; Bacteremia/drug therapy/mortality/microbiology; Middle Aged; Aged, 80 and over; Italy/epidemiology; Treatment Outcome; Adult; Risk Factors; Colistin/therapeutic use; Acinetobacter baumannii; Bacteremia; Cefiderocol; Clinical failure; Combination therapy;