Comparative analysis of treatment outcomes and risk factors associated with different combination antimicrobial regimens in patients with multidrug-resistant Acinetobacter baumannii pneumonia
Abstract
Background: Multidrug-resistant Acinetobacter baumannii (MDRAB) pneumonia is a major cause of mortality in hospital-acquired infections due to extensive drug resistance and limited therapeutic options. Optimizing treatment and identifying mortality-related factors are urgently needed.
Objective: To compare the efficacy of different antibacterial regimens in MDRAB pneumonia and determine independent risk factors for 28-day all-cause mortality.
Methods: This single-center retrospective cohort study included 142 MDRAB pneumonia patients from February 2022 to February 2025. Patients were divided into three groups: Group A, sulbactam-containing combinations (n = 63); Group B, polymyxins + tigecycline (n = 45); Group C, other regimens (n = 34). Outcomes included bacterial resistance patterns, 28-day mortality, dynamic PCT and CRP levels, APACHE II and SOFA scores, and lymphocyte subsets. Multivariate logistic regression identified mortality predictors.
Results: Group A showed the lowest resistance to cefoperazone/sulbactam (30.16%) and the highest sensitivity (71.43%, both P< 0.05). Group B had the highest tigecycline resistance (31.11%). The 28-day mortality rates were 39.68% (A), 60.00% (B), and 64.71% (C) (P = 0.028). Independent mortality predictors were APACHE II, SOFA, and CD4+/CD8+ ratio (all P< 0.01). On day 7, Group A had the lowest PCT, while Group C showed the smallest declines in PCT and CRP. Group A exhibited the highest CD4+/CD8+ ratio.
Conclusion: Sulbactam-based…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 142 participants or records.
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