Predictors of mortality and therapeutic efficacy in carbapenem-resistant Acinetobacter baumannii bacteremia

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.

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Publication Details

Journal
Journal of Infection
Published
2026-03-31
DOI
https://doi.org/10.1016/j.jinf.2026.106742
Citations
1
Primary Topic
Antibiotic Resistance in Bacteria
Type
article
Field-Weighted Citation Impact
10.19
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article

Predictors of mortality and therapeutic efficacy in carbapenem-resistant Acinetobacter baumannii bacteremia

Nicolò Presa, Sergio Carbonara, Adriana Boccuzzi, Vincenzo Scaglione et al.
1 citations
Journal of Infection
Antibiotic Resistance in Bacteria
10.19
article

Predictors of mortality and therapeutic efficacy in carbapenem-resistant Acinetobacter baumannii bacteremia

Nicolò Presa, Sergio Carbonara, Adriana Boccuzzi, Vincenzo Scaglione, Giosuele Calabria, Ylenia Russotto, Lorenzo Surace, Nicoletta Boffa, Sara Palma Gullì, Laura Montemurro, Novella Carannante, Paolo Grossi, Luigi Spadafora, Francesca Serapide, Francesco Alessandri, Stefano Cappanera, Pierluigi Brugnaro, Valentina Galfo, Luca Pipitò, Riccardo Serraino, Chiara Iaria, Emanuela Sensi, Nicholas Geremia, Andrea Lombardi, Alessandra Calabresi, R. Mascianà, Emmanuele Venanzi Rullo, Carlo Pallotto, Silvia Corcione, Rosa Spinelli, Margherita Macera, Mario Pantaleoni, Alice Picciarella, Luisa Frallonardo, Felicia Anna Spadavecchia, Maddalena Peghin, Linda Erario, Francesco Saverio Serino, Alessia Mattei, Giuseppe Vittorio De Socio, Lucia Fontanelli Šuleková, Giuseppe Pipitone, Marianna Meschiari, Omar Simonetti, Alfredo Kunkar, Fabrizio Bar, Giuseppe Caviglia, Alessandro De Felice, Paolo Vassalini, Nicola Coppola, Francesco Giuseppe De Rosa, Luciano Caterini, Mario Tumbarello, Michela Comi, Beatrice Tiri, Filippo Givone, Antonio Mastroianni, Antonella Gallicchio, G. Nicolò, Francesco Di Gennaro, Giovanna De Candia, Bruno Cacopardo, Elena Momesso, Roberto Papale, Alessandra Bandera, Annamaria Cattelan, Francesco Cozzolino, Marco Libanore, Marco Visicaro, Ana Mariño, Maria Di Stasi, Debora Altobelli, Mariano Corrado, Stefano Di Bella, Mario Alessio Guarano, Alessandro Franzò, Giusy Tiseo, Mariachiara Ippolito, Giuseppe Biondi-Zoccai, Giuseppe Fiorentino, Caterina Di Cecco, Annalisa Saracino, Saverio Nicolosi, Giuseppe Nunnari, Alessandra Mularoni, Alessandra Oliva, Claudio Maria Mastroianni, Ivan Gentile, Diletta Testi, Andrea Cortegiani, Alessandro Russo, Antonio Vena, Giancarlo Ceccarelli, Simona Tuberga, Cristina Mussini, Marco Falcone, Daniela Tatò, Marco Bernardi, Matteo Bassetti, Antonio Cascio
article en
1 citations

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.

Journal of InfectionVol. 92(5)
University of Messina (IT), University of Insubria (IT), University of Padua (IT), University of Trieste (IT), Università Campus Bio-Medico (IT), University of Ferrara (IT), University of Perugia (IT), Santa Maria Nuova Hospital (IT), Martin University (US), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico (IT), Magna Graecia University (IT), University of Catania (IT), Azienda Ospedaliera Citta' della Salute e della Scienza di Torino (IT), Azienda Ospedaliera di Perugia (IT), Ospedale degli Infermi (IT), Fondazione Ricerca Molinette (IT), Ospedale Santa Maria alle Scotte (IT), Maria Cecilia Hospital (IT), Azienda Ospedaliera di Cosenza (IT), Ospedale di San Donà di Piave (IT), Ospedale Garibaldi (IT), Azienda Ospedaliero-Universitaria di Modena (IT), Ospedale Santa Maria (IT), CTO Andrea Alesini (IT), Federico II University Hospital (IT), Azienda Ospedaliera Sant'Andrea (IT), University of Campania "Luigi Vanvitelli" (IT), Ospedale di Belcolle (IT), Ospedale Annunziata di Cosenza (IT), Regione del Veneto (IT), Ospedale Santa Maria Goretti (IT), Ospedale Monaldi (IT), Azienda di Rilievo Nazionale ed Alta Specializzazione (IT), Ospedale Policlinico San Martino (IT), Azienda Ospedaliera Universitaria Policlinico "Paolo Giaccone" di Palermo (IT), Ospedale D. Cotugno (IT), Department of Public Health (MM), Ospedale San Luigi Gonzaga (IT), St. Anna Hospital (DE), Azienda Ospedaliera Nazionale SS. Antonio e Biagio e Cesare Arrigo (IT), Ospedale Civile di Venezia (IT), BioAge (Italy) (IT), Azienda Ospedaliera Universitaria Pisana (IT), Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione (IT), University of Bari Aldo Moro (IT), University of Reggio Calabria (IT), University of Naples Federico II (IT), University of Genoa (IT), Sapienza University of Rome (IT), University of Palermo (IT)
Good health and well-being
Openalex Percentile: Top 2%
Antibiotic Resistance in Bacteria
10.19
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