Predictors of Acute Kidney Injury and 28-Day Mortality in Carbapenem-Resistant Acinetobacter baumannii Complex Bacteremia
- Abstract
- Colistin is an, antibiotic used to treat carbapenem-resistant Acinetobacter baumannii complex (CRABC) infection. However, colistin is well known for its nephrotoxicity. To accurately assess the effects of colistin on acute kidney injury (AKI) and 28-day mortality, we investigated the risk factors associated with AKI and mortality in patients with CRABC bacteremia who received or never received colistin. Patients with CRABC bacteremia aged ≥18 years were retrospectively identified for 3 years at five tertiary teaching hospitals. AKI was defined by using the Kidney Disease Improving Global Outcomes criteria. AKI developed in 103 (34.9%) of the 295 patients enrolled patients. AKI developed more frequently in patients who received colistin than in patients who did not (46.7% vs. 29.5%, p = 0.004). Multivariate analysis showed that intravenous colistin usage was an independent risk factor for AKI in these patients. Nonfatal disease, catheter-related bloodstream infection, and administration of colistin were protective factors for 28-day mortality. However, the sequential organ failure assessment score and AKI were associated with poor outcomes. In conclusion, colistin may be a double-edged sword; although it causes AKI, it also reduces 28-day mortality in patients with CRABC bacteremia. Therefore, colistin administration as an appropriate antibiotic may improve CRABC bacteremia prognosis, despite its nephrotoxicity.
- All Author(s)
- S. N. Yu
; T. Kim
; S. Y. Park
; Y. M. Lee
; K. H. Park
; E. J. Lee
; M. H. Jeon
; E. J. Choo
; T. H. Kim
; M. S. Lee
- Intsitutional Author(s)
- 유시내; 전민혁
- Issued Date
- 2021
- Type
- Article
- Keyword
- 28-day mortality; Acinetobacter baumannii; KDIGO criteria; acute kidney injury; bacteremia; carbapenem-resistant; colistin
- Publisher
- Mary Ann Liebert
- ISSN
- 1076-6294
; 1931-8448
- Citation Title
- Microbial drug resistance
- Citation Volume
- 27
- Citation Number
- 8
- Citation Start Page
- 1029
- Citation End Page
- 1036
- Language(ISO)
- eng
- DOI
- 10.1089/mdr.2020.0312
- URI
- http://schca-ir.schmc.ac.kr/handle/2022.oak/2460
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