ORIGINAL RESEARCH article
Front. Med.
Sec. Infectious Diseases: Pathogenesis and Therapy
Carbapenem-resistant Acinetobacter baumannii Bloodstream Infections in Critically Ill Patients: Prognostic Factors and Development of a Nomogram
Provisionally accepted
- 1The First Affiliated Hospital of Dali University, Dali, China
- 2Hunan University of Medicine General Hospital, Huaihua, China
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Objective: This retrospective study aimed to identify the clinical features and prognostic determinants in intensive care unit (ICU) patients with carbapenem-resistant Acinetobacter baumannii (CRAB) bloodstream infection (BSI) and to establish a personalized risk prediction model. Methods: This retrospective cohort study included 185 ICU patients with CRAB-BSI at a tertiary care hospital between 2013 and 2023. Based on 30-day outcomes, patients were categorized into survival and non-survival groups. Independent risk factors for mortality were identified through univariate and multivariate logistic regression analyses. These factors were used to construct a nomogram prediction model. Model performance was evaluated by assessing discrimination using the area under the receiver operating characteristic curve with a calibration plot, and clinical utility via decision curve analysis. Results: The 30-day mortality rate among ICU patients with CRAB-BSI was 60.0%. Multivariate analysis revealed that age (odds ratio [OR] = 1.04, 95% confidence interval [CI]: 1.02–1.07), impaired consciousness (OR = 5.10, 95% CI: 2.27–11.45), prior corticosteroid use (OR = 5.82, 95% CI: 2.10–16.12), Sequential Organ Failure Assessment (SOFA) score (OR = 1.26, 95% CI: 1.12–1.42), and C-reactive protein (CRP) level (OR = 1.01, 95% CI: 1.01–1.02) were independent risk factors for 30-day mortality. A nomogram incorporating these variables achieved an area under the curve (AUROC) of 0.863 for predicting 30-day mortality risk. The calibration curve indicated excellent concordance between predictions and observed outcomes, and decision curve analysis demonstrated significant clinical net benefit over a wide range of probability thresholds. Conclusion: Mortality is high in ICU patients with CRAB-BSI and is significantly associated with age, impaired consciousness, corticosteroid use, SOFA score, and CRP level. The developed nomogram exhibits strong predictive accuracy and may function as a practical tool for quantitative management decisions.
Keywords: 30-day mortality, Bloodstream infection, Carbapenem-resistant Acinetobacter baumannii, Intensive Care Unit, nomogram, Risk factors
Received: 05 Jan 2026; Accepted: 16 Feb 2026.
Copyright: © 2026 Huang, Gu, Wang and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Sanhu Wang
Fuxing Li
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