Risk factors associated with bloodstream infections caused by Acinetobacter baumannii in hospital settings: A systematic review and meta-analysis

Abstract

<h2>Abstract</h2><h3>Background</h3> <i>Acinetobacter baumannii</i> represents a significant public health issue in hospital settings because of its high-level resistance to various antimicrobials. Early detection of patients at risk of <i>A. baumannii</i> bloodstream infection (BSI) is crucial. <h3>Objectives</h3> To investigate risk factors for <i>A. baumannii</i> BSI by means of a systematic review and meta-analysis. <h3>Methods</h3> MEDLINE, Embase, Web of Science and Scopus libraries were used to systematically search available evidence. Two authors independently performed screening, full-text review, data extraction and quality assessments. A third author resolved any conflicts. A meta-analysis was conducted with common and random effects models for risk factors investigated in at least four studies. <h3>Results</h3> Overall, 25 studies (13 cohort and 12 case-control studies) were included. All studies were classified as good quality studies using the Newcastle-Ottawa scale (≥ 6/9 stars). Most studies were performed in intensive care units on critically ill patients. Only one study used simple logistic regression, while the majority performed multivariate regression. The meta-analysis revealed that previous antimicrobial therapy (OR 2.30, 95 % CI 1.89 - 2.81), central-line catheter use (OR 3.51, 95 % CI 2.45 – 5.01) and mechanical ventilation (OR 3.29, 95 % CI 2.13 - 5.09) were associated with an increased risk of developing <i>A. baumannii</i> BSI. <h3>Conclusion</h3> Previous antimicrobial therapy, central-line catheter use, and mechanical ventilation were associated with <i>A. baumannii</i> bloodstream infections. Infection prevention and control programmes should address these risk factors to reduce such infections.

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