Predictors of mortality and therapeutic efficacy in carbapenem-resistant Acinetobacter baumannii bacteremia
Year: 2026
Type: article
Study design: Observational Study
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.
Source: Journal of Infection
Authors: Alessandro Russo, Sara Palma Gullì, Antonio Vena, Luigi Spadafora, Marco Bernardi, Silvia Corcione, Giancarlo Ceccarelli, Francesco Alessandri, Claudio Maria Mastroianni, Alessandra Oliva, Emmanuele Venanzi Rullo, Giuseppe Caviglia, Andrea Cortegiani, Mariachiara Ippolito, Giuseppe Nunnari, Francesco Di Gennaro, Annalisa Saracino, Andrea Marino, Bruno Cacopardo, Giusy Tiseo, Marco Falcone, Valentina Galfo, Chiara Iaria, Giuseppe Pipitone, Antonio Cascio, Sergio Carbonara, Laura Montemurro, Francesco Saverio Serino, Nicoletta Boffa, Marco Libanore, Francesco Giuseppe De Rosa, Alessia Mattei, Alessandra Calabresi, Mario Tumbarello, Lucia Fontanelli Šuleková, Carlo Pallotto, Pierluigi Brugnaro, Roberta Mascianà, Beatrice Tiri, Nicola Coppola, Giosuele Calabria, Alessandra Bandera, Andrea Lombardi, Paolo Vassalini, Novella Carannante, Vincenzo Scaglione, Marianna Meschiari, Omar Simonetti, Alessandra Mularoni, Fabrizio Bar, Riccardo Serraino, Cristina Mussini, Matteo Bassetti, Giuseppe Biondi-Zoccai, Francesca Serapide, Luisa Frallonardo, Luca Pipitò, Annamaria Cattelan, Ylenia Russotto, Saverio Nicolosi, Mario Pantaleoni, Diletta Testi, Giuseppe Vittorio De Socio, Debora Altobelli, Elena Momesso, Alessandro Felice, Mario Alessio Guarano, Stefano Di Bella, Caterina Di Cecco, Antonella Gallicchio, Maddalena Peghin, Filippo Givone, Paolo Grossi, Luciano Caterini, Linda Erario, Mariano Franco Corrado, Margherita Macera, Alfredo Kunkar, Giovanna Maria Nicolò, Alessandro Franzò, Giovanna De Candia, Francesco Cozzolino, Rosa Spinelli, Maria Di Stasi, Roberto Papale, Felicia Anna Spadavecchia, Daniela Tatò, Ivan Gentile, Adriana Boccuzzi, Simona Tuberga, Lorenzo Surace, Giuseppe Fiorentino, Stefano Cappanera, Emanuela Sensi, Marco Visicaro, Antonio Mastroianni, Michela Comi, Nicolò Presa, Nicholas Geremia, Alice Picciarella
Institutions: Magna Graecia University, Azienda Ospedaliero-Universitaria "Renato Dulbecco", Ospedale Policlinico San Martino, University of Genoa, Ospedale Santa Maria Goretti, Sapienza University of Rome, University of Turin, University of Messina, Azienda Ospedaliera Universitaria Policlinico "Paolo Giaccone" di Palermo, University of Palermo, Ospedale Garibaldi, University of Bari Aldo Moro, University of Catania, University of Pisa, Azienda Ospedaliera Universitaria Pisana, Ospedale di San Donà di Piave, University of Ferrara, Arcispedale Sant'Anna, Università Campus Bio-Medico, Azienda Ospedaliera Nazionale SS. Antonio e Biagio e Cesare Arrigo, University of Siena, Azienda Sanitaria Locale Salerno, University of Perugia, Azienda Ospedaliera S.Maria, University of Campania "Luigi Vanvitelli", Ospedale D. Cotugno, University of Milan, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Ospedale di Belcolle, University of Padua, Azienda Ospedale - Università Padova, Azienda Ospedaliero-Universitaria di Modena, University of Trieste, Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione, Ospedale San Luigi Gonzaga, University of Modena and Reggio Emilia, Maria Cecilia Hospital, University of Insubria, Aziende Socio Sanitarie Territoriale dei Sette Laghi, Federico II University Hospital, University of Naples Federico II, Ospedale Monaldi, Azienda Ospedaliera di Cosenza, Azienda Sanitaria Provinciale di Cosenza
Language: English
Subfield: Molecular Medicine
Domain: Life Sciences
Open Access status: gold
Estimated APC paid: $4,030
OpenAlex ID: W7143954402