Clinical characteristics and outcomes of community and hospital-acquired Acinetobacter baumannii bacteremia.

Abstract

PURPOSE:

We aimed to characterize clinical manifestations of the patients with bacteremia due to community-acquired Acinetobacter baumannii and evaluate the outcomes of these patients.

METHODS:

We conducted a retrospective study to include adult patients with A. baumannii bacteremia and then classified them into two groups: community-acquired A. baumannii bacteremia and hospital-acquired A. baumannii bacteremia. Characteristics and outcomes between 2 groups were compared. The Galleria mellonella infection survival model was used to determine the virulence of A. baumannii in these 2 groups.

RESULTS:

There were 63 patients with A. baumannii bacteremia: 21 patients with community-acquired (CA) bacteremia and 42 patients with hospital-acquired (HA) bacteremia. Three patients with CA bacteremia were excluded due to healthcare-associated risks of infection. The remaining 18 patients with CA bacteremia had carbapenem-susceptible A. baumannii (CA-CSAB). Among the 42 patients with HA bacteremia, 11 patients had carbapenem-susceptible A. baumannii (HA-CSAB) and 31 patients had carbapenem-resistant A. baumannii (HA-CRAB). The 30-day mortality rates of those with CA-CSAB did not differ from those with HA-CSAB bacteremia but were significantly lower than those with HA-CRAB (p = 0.003). The factors influencing 30-day mortality were infection with CRAB (p = 0.004), appropriate empirical antimicrobial therapy (p = 0.002), and higher Acute Physiology and Chronic Health Evaluation II score (p < 0.001). The G. mellonella assay showed no differences in survival rates among CA-CSAB, HA-CSAB, and HA-CRAB.

CONCLUSIONS:

Patients with bacteremia due to CA-CSAB and HA-CSAB had similar outcomes. Similar virulences of CA-CSAB and HA-CSAB were confirmed with the G. mellonella infection model.

• Authors: Sarunyou Chusri, Virasakdi Chongsuvivatwong, Kachornsakdi Silpapojakul, Kamonnut Singkhamanan, Thanaporn Hortiwakul, Boonsri Charernmak, Yohei Doi
• Journal: Journal of microbiology, immunology, and infection = Wei mian yu gan ran za zhi (J Microbiol Immunol Infect) Vol. 52 Issue 5 Pg. 796-806 (Oct 2019) ISSN: 1995-9133 [Electronic] England
• PMID: 31031096 (Publication Type: Journal Article)
• Copyright: Copyright © 2019. Published by Elsevier B.V.

Chemical References

• Anti-Bacterial Agents
• Carbapenems

Topics

• Acinetobacter Infections (drug therapy, microbiology, physiopathology)
• Acinetobacter baumannii (drug effects)
• Adult
• Aged
• Animals
• Anti-Bacterial Agents (therapeutic use)
• Bacteremia (drug therapy, physiopathology)
• Carbapenems (therapeutic use)
• Community-Acquired Infections (drug therapy, microbiology, physiopathology)
• Disease Models, Animal
• Female
• Hospitals
• Humans
• Kaplan-Meier Estimate
• Larva (microbiology)
• Male
• Microbial Sensitivity Tests
• Middle Aged
• Mortality
• Retrospective Studies
• Risk Factors
• Virulence