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There has been a continuing controversy about whether infection with  Acinetobacter baumannii  increases morbidity and mortality independently of the effect of other confounding factors.    Methods  We performed a systematic review of matched case-control and cohort studies examining the mortality attributable to infection with or acquisition of  A. baumannii  (infection or colonization). We included in our review studies that compared mortality and/or morbidity of patients with acquisition of or infection with  A. baumannii  (cases) with the outcomes of matched patients without  A. baumannii  isolation from clinical specimens (controls). The relevant studies were identified from searches of the PubMed and the Cochrane Library databases. Two independent reviewers performed the literature search, study selection, and data extraction from nine identified relevant studies.    Results  The attributable mortalities, in the hospital and in the intensive care unit, of patients with  A. baumannii  infection in six matched case-control studies included in our review ranged from 7.8% to 23% and from 10% to 43%, respectively. In addition, a statistically significantly higher mortality was reported for patients with  A. baumannii  acquisition; that is, colonization or infection (cases) compared with controls without such an acquisition in all four reviewed studies that reported data on this comparison.    Conclusion  Although definitive statements about the mortality attributable to the acquisition of  A. baumannii  cannot be made from the available studies because of their methodological heterogeneity, the reviewed data suggest that infection with or acquisition of  A. baumannii  seems to be associated with increased mortality.

critical care

Attributable mortality of Acinetobacter baumannii infections in critically ill patients: a systematic review of matched cohort and case-control studies.