{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T16:16:02Z","timestamp":1778775362581,"version":"3.51.4"},"reference-count":38,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,5,9]],"date-time":"2024-05-09T00:00:00Z","timestamp":1715212800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"Background<\/jats:title>This study aimed to explore the risk factors for failed treatment of carbapenem-resistant Acinetobacter baumannii<\/jats:italic> ventilator-associated pneumonia (CRAB-VAP) with tigecycline and to establish a predictive model to predict the incidence of failed treatment and the prognosis of CRAB-VAP.<\/jats:p><\/jats:sec>Methods<\/jats:title>A total of 189 CRAB-VAP patients were included in the safety analysis set from two Grade 3 A national-level hospitals between 1 January 2022 and 31 December 2022. The risk factors for failed treatment with CRAB-VAP were identified using univariate analysis, multivariate logistic analysis, and an independent nomogram to show the results.<\/jats:p><\/jats:sec>Results<\/jats:title>Of the 189 patients, 106 (56.1%) patients were in the successful treatment group, and 83 (43.9%) patients were in the failed treatment group. The multivariate logistic model analysis showed that age (OR\u2009=\u20091.04, 95% CI: 1.02, 1.07, p<\/jats:italic>\u2009=\u20090.001), yes. of hypoproteinemia (OR\u2009=\u20092.43, 95% CI: 1.20, 4.90, p<\/jats:italic>\u2009=\u20090.013), the daily dose of 200\u2009mg (OR\u2009=\u20092.31, 95% CI: 1.07, 5.00, p<\/jats:italic>\u2009=\u20090.034), yes. of medication within 14\u2009days prior to surgical intervention (OR\u2009=\u20092.98, 95% CI: 1.19, 7.44, p<\/jats:italic>\u2009=\u20090.019), and no. of microbial clearance (OR\u2009=\u20090.31, 95% CI: 0.14, 0.70, p<\/jats:italic>\u2009=\u20090.005) were risk factors for the failure of tigecycline treatment. Receiver operating characteristic (ROC) analysis showed that the AUC area of the prediction model was 0.745 (0.675\u20130.815), and the decision curve analysis (DCA) showed that the model was effective in clinical practice.<\/jats:p><\/jats:sec>Conclusion<\/jats:title>Age, hypoproteinemia, daily dose, medication within 14\u2009days prior to surgical intervention, and microbial clearance are all significant risk factors for failed treatment with CRAB-VAP, with the nomogram model indicating that high age was the most important factor. Because the failure rate of CRAB-VAP treatment with tigecycline was high, this prediction model can help doctors correct or avoid risk factors during clinical treatment.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpubh.2024.1385118","type":"journal-article","created":{"date-parts":[[2024,5,9]],"date-time":"2024-05-09T05:06:05Z","timestamp":1715231165000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["A novel multivariate logistic model for predicting risk factors of failed treatment with carbapenem-resistant Acinetobacter baumannii ventilator-associated pneumonia"],"prefix":"10.3389","volume":"12","author":[{"given":"Ke","family":"Sun","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fangchen","family":"Peng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kaiqiang","family":"Xu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yong","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xuanping","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nan","family":"Shang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chao","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2024,5,9]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1455","DOI":"10.1093\/cid\/ciy375","article-title":"Acinetobacter pneumonia: improving outcomes with early identification and appropriate therapy","volume":"67","author":"Vazquez Guillamet","year":"2018","journal-title":"Clin Infect Dis"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"940","DOI":"10.1086\/671740","article-title":"Secular trends in gram-negative resistance among urinary tract infection hospitalizations in the United States, 2000-2009","volume":"34","author":"Zilberberg","year":"2013","journal-title":"Infect Control Hosp Epidemiol"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1625","DOI":"10.1093\/jac\/dkr167","article-title":"Trend analysis of antimicrobial consumption and development of resistance in non-fermenters in a tertiary care hospital in Delhi, India","volume":"66","author":"Goel","year":"2011","journal-title":"J Antimicrob Chemother"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1730","DOI":"10.1080\/22221751.2022.2093134","article-title":"Epidemiological and genetic characteristics of clinical carbapenem-resistant Acinetobacter baumannii strains collected countrywide from hospital intensive care units (ICUs) in China","volume":"11","author":"Liu","year":"2022","journal-title":"Emerg Microbes Infect"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"e37788","DOI":"10.1371\/journal.pone.0037788","article-title":"Increase of carbapenem-resistant Acinetobacter baumannii infection in acute care hospitals in Taiwan: association with hospital antimicrobial usage","volume":"7","author":"Su","year":"2012","journal-title":"PLoS One"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"103887","DOI":"10.1016\/j.micpath.2019.103887","article-title":"Global prevalence of colistin resistance in clinical isolates of Acinetobacter baumannii: a systematic review and meta-analysis","volume":"139","author":"Pormohammad","year":"2020","journal-title":"Microb Pathog"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"371","DOI":"10.1186\/s12879-017-2471-0","article-title":"Pneumonia caused by extensive drug-resistant Acinetobacter baumannii among hospitalized patients: genetic relationships, risk factors and mortality","volume":"17","author":"Li","year":"2017","journal-title":"BMC Infect Dis"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"822","DOI":"10.1016\/j.jmii.2023.04.004","article-title":"T-CARE (Taiwan critical care and infection) group. Mortality and ventilator dependence in critically ill patients with ventilator-associated pneumonia caused by carbapenem-resistant Acinetobacter baumannii","volume":"56","author":"Kao","year":"2023","journal-title":"J Microbiol Immunol Infect"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"593","DOI":"10.1016\/j.jinf.2019.09.012","article-title":"The global prevalence of multidrug-resistance among Acinetobacter baumannii causing hospital-acquired and ventilator-associated pneumonia and its associated mortality: a systematic review and meta-analysis","volume":"79","author":"Mohd Sazlly Lim","year":"2019","journal-title":"J Infect"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"ciad428","DOI":"10.1093\/cid\/ciad428","article-title":"Infectious Diseases Society of America 2023 guidance on the treatment of antimicrobial resistant gram-negative infections","volume":"18","author":"Tamma","year":"2023","journal-title":"Clin Infect Dis"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"908.e1","DOI":"10.1016\/j.cmi.2017.10.033","article-title":"Antibiotic strategies and clinical outcomes in critically ill patients with pneumonia caused by carbapenem-resistant Acinetobacter baumannii","volume":"24","author":"Liang","year":"2018","journal-title":"Clin Microbiol Infect"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"115","DOI":"10.1016\/j.diagmicrobio.2012.11.009","article-title":"Carbapenem-resistant Enterobacteriaceae: a review of treatment and outcomes","volume":"75","author":"van Duin","year":"2013","journal-title":"Diagn Microbiol Infect Dis"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"ofx176","DOI":"10.1093\/ofid\/ofx176","article-title":"Prevalence of carbapenem-resistant gram-negative infections in the United States predominated by Acinetobacter baumannii and Pseudomonas aeruginosa","volume":"4","author":"Cai","year":"2017","journal-title":"Open Forum Infect Dis"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"463","DOI":"10.1016\/j.ijantimicag.2013.01.020","article-title":"All-cause mortality imbalance in the tigecycline phase 3 and 4 clinical trials[J]","volume":"41","author":"McGovern","year":"2013","journal-title":"Int J Antimicrob Agents"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"e01864-19","DOI":"10.1128\/jcm.01864-19","article-title":"The clinical and laboratory standards institute subcommittee on antimicrobial susceptibility testing: background, organization, functions, and processes","volume":"58","author":"Weinstein","year":"2020","journal-title":"J Clin Microbiol"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"388","DOI":"10.1164\/rccm.200405-644ST","article-title":"Infectious Diseases Society of America. 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Guideline: appropriate use of tigecycline","volume":"100","author":"Brink","year":"2010","journal-title":"S Afr Med J"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"76","DOI":"10.4103\/jms.jms_25_17","article-title":"World health organization releases global priority list of antibiotic-resistant bacteria to guide research, discovery, and development of new antibiotics","volume":"32","author":"Shrivastava","year":"2018","journal-title":"J Med Soc"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"92","DOI":"10.3389\/fphar.2019.00092","article-title":"Acinetobacter baumannii ventilator-associated pneumonia: clinical efficacy of combined antimicrobial therapy and in vitro drug sensitivity test results","volume":"10","author":"Huang","year":"2019","journal-title":"Front Pharmacol"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"1140","DOI":"10.1016\/j.ajic.2019.03.003","article-title":"Predictors of mortality in patients infected with 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Care"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"106930","DOI":"10.1016\/j.ijantimicag.2023.106930","article-title":"Geographical patterns of in vitro susceptibilities to tigecycline and colistin among worldwide isolates of Acinetobacter baumannii, Escherichia coli and Klebsiella pneumoniae: data from the antimicrobial testing leadership and surveillance (ATLAS) programme, 2016-2021","volume":"62","author":"Wang","year":"2023","journal-title":"Int J Antimicrob Agents"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"1194","DOI":"10.1097\/CCM.0000000000000933","article-title":"Excess mortality associated with Colistin-Tigecycline compared with Colistin-Carbapenem combination therapy for extensively drug-resistant Acinetobacter baumannii bacteremia: a multicenter prospective observational study","volume":"43","author":"Cheng","year":"2015","journal-title":"Crit Care Med"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"1332","DOI":"10.1097\/CCM.0000000000001029","article-title":"Combination therapy for extreme drug-resistant Acinetobacter baumannii: ready for prime time?","volume":"43","author":"Spellberg","year":"2015","journal-title":"Crit Care Med"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"507","DOI":"10.1080\/23744235.2018.1423703","article-title":"Use of Monte Carlo simulation to evaluate the efficacy of tigecycline and minocycline for the treatment of pneumonia due to carbapenemase-producing Klebsiella pneumoniae","volume":"50","author":"Ni","year":"2018","journal-title":"Infect Dis"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"1249","DOI":"10.1016\/j.jiph.2023.05.024","article-title":"Short versus long course of colistin treatment for carbapenem-resistant A. baumannii in critically ill patients: a propensity score matching study","volume":"16","author":"Katip","year":"2023","journal-title":"J 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