Abstract: Acinetobacter baumannii  can cause a serious infection in solid-organ transplant (SOT) recipients, and more data on A. baumannii  infection is needed. We sought to investigate the epidemiology and distribution of A. baumannii  isolates in SOT recipients. We also investigated the risk factors for overall in-hospital mortality and infection-related 30-day mortality using multivariate logistic regression analysis. A double-center retrospective study of SOT recipients who were infected with A. baumannii  between January 2003 and January 2015 was conducted. A total of 71 individuals developed 93 episodes of A. baumannii  infection, with a mean age of 44.5 years (44.5±11.9 years). Ninety percent of recipients had nosocomial origin A. baumannii  infection, with the bloodstream as the most common site of infection (32.4%). Septic shock developed in 23.9% (17 of 71) of all recipients with A. baumannii  infection. Morbidity and mortality rates of A. baumannii  infections were high in SOT recipients. The incidence rate of A. baumannii  infection in SOT recipients was 3.9% (71 of 1,821). Overall in-hospital mortality and infection-related 30-day mortality were 53.5% (38 of 71) and 40.8% (29 of 71), respectively. Risk factors independently associated with overall in-hospital mortality were mechanical ventilation at onset of A. baumannii  infection (odds ratio [OR] 6.29, 95% confidence interval [CI] 1.48–26.85; P =0.013), liver or liver–kidney transplantation (OR 15.33, 95% CI 1.82–129.18; P =0.012), and late-onset A. baumannii  infection (OR 7.61, 95% CI 1.07–54.36; P =0.043). A platelet count <50,000/mm³ (OR 12.76, 95% CI 1.28–126.81; P =0.030) and mechanical ventilation at onset of A. baumannii  infection (OR 189.98, 95% CI 13.23–2,728.81; P <0.001) were identified as independent risk factors for infection-related 30-day mortality. In conclusion, the morbidity and mortality rates of A. baumannii infections were high in SOT recipients. Mechanical ventilation at onset of A. baumannii  infection was associated with higher overall in-hospital mortality and infection-related mortality. For overall in-hospital mortality, liver or liver–kidney transplantation and late-onset A. baumannii  infection, and for infection-related mortality, thrombocytopenia were also risk factors, respectively.
Keywords: A. baumannii , infection, predictors, mortality, solid-organ transplantation