Prognostic Indicators of Carbapenem-Resistant Acinetobacter baumannii Infection: A Meta-Analysis and Systematic Review.

BACKGROUND

Carbapenem-resistant Acinetobacter baumannii (CRAB) infections are clinically difficult to treat owing to their lack of effective treatments and high mortality rates. This calls for the development of prognostic indicators to facilitate risk stratification and patient management.

AIMS: To identify prognostic indicators of CRAB infections through a systematic review and meta-analysis.

METHODS

A systematic search was performed on PubMed, Embase, and Cochrane Library up to November 2024. Studies that reported the CRAB infections and their adverse outcomes (e.g., mortality, acute kidney injury, recurrent infections) were eligible for enrollment. Data were extracted from the studies by two reviewers, and the quality of the studies was determined using the Newcastle-Ottawa Scale (NOS). Meta-analysis was performed using random-effects or fixed-effects models while considering the heterogeneity determined using the I² statistics.

RESULTS

Fourteen studies comprising 2250 patients were enrolled in the study. Notably, cardiovascular disease (OR: 1.59, 95% CI: 1.17-2.17), acute kidney injury (OR: 3.15, 95% CI: 1.69-5.88), shock (OR: 2.33, 95% CI: 1.50-3.63), pneumonia (OR: 1.28, 95% CI: 1.02-1.60), hematologic malignancy (OR: 2.23, 95% CI: 1.55-3.21), neutropenia (OR: 2.74, 95% CI: 1.48-5.06), and thrombocytopenia (OR: 1.49, 95% CI: 1.10-2.02) were found to be significant prognostic indicators predicting poor outcomes. The use of steroid therapy (OR: 1.29, 95% CI: 1.01-1.64) was linked to increased mortality risk.

CONCLUSION

In this meta-analysis, we detected several prognostic indicators that correlated with poor adverse outcomes in patients with CRAB infections, which may help clinical decision-making and risk-stratification strategies. Trial Registration: PROSPERO 2024 CRD42024565429 Available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024565429.