Carbapenem-Nonsusceptible Acinetobacter baumannii, 8 US Metropolitan Areas, 2012–2015

Abstract

In healthcare settings, Acinetobacter spp. bacteria commonly demonstrate antimicrobial resistance, making them a major treatment challenge. Nearly half of Acinetobacter organisms from clinical cultures in the United States are nonsusceptible to carbapenem antimicrobial drugs. During 2012–2015, we conducted laboratory- and population-based surveillance in selected metropolitan areas in Colorado, Georgia, Maryland, Minnesota, New Mexico, New York, Oregon, and Tennessee to determine the incidence of carbapenem-nonsusceptible A. baumannii cultured from urine or normally sterile sites and to describe the demographic and clinical characteristics of patients and cases. We identified 621 cases in 537 patients; crude annual incidence was 1.2 cases/100,000 persons. Among 598 cases for which complete data were available, 528 (88.3%) occurred among patients with exposure to a healthcare facility during the preceding year; 506 (84.6%) patients had an indwelling device. Although incidence was lower than for other healthcare-associated pathogens, cases were associated with substantial illness and death.

National prevalence estimates for resistant Enterobacteriaceae and Acinetobacter species in hospitalized patients in the United States

“…The CRE rate of an estimated 2.93 incidence cases per 100,000 population in a surveillance study of seven US communities cannot be compared with the Carb-NS rate of 0.7 per 1000 admissions reported here, as the methods for detecting carbapenem resistance, populations examined (surveillance versus inpatient), and denominator were very different (Guh et al, 2015). Surveillance methodology was also used to derive a Carb-NS A. baumanni rate of 1.2 cases/100,000 persons (Bulens et al, 2018) (compared with the rate of 0.3 per 1000 admissions for Carb-NS Acinetobacter spp. reported here).…”

A Study on Burden of Carbapenem-Resistant Pseudomonas aeruginosa and Acinetobacter baumannii Infections in a Tertiary Care Hospital of Eastern India

“…14,15 CRPsA and CRAB cases were identified when isolates were resistant to ≥1 carbapenem, for 10µg imipenem disc (when zone diameter was ≤15mm for P. aeruginosa or ≤18mm for A. baumanii) or 10µg meropenem disc (with ≤15mm for P. aeruginosa or ≤14mm for A. baumanii). 1,8 Multidrug-resistant (MDR) P. aeruginosa or A. baumanii was defined by resistance to ≥1 agent in ≥3 antimicrobial classes. 16 The other antibiotic discs used were ceftriaxone (30µg only for A. baumannii), ceftazidime (30µg), piperacillintazobactum (100/10µg), ticarcillin-clavulanate (75/10µg), aztreonam (30µg, only for P. aeruginosa), ciprofloxacin (5µg), levofloxacin (5µg), lomefloxacin (10µg), amikacin (30µg), trimethoprim-sulfamethoxazole (1.25/23.75μg only for A. baumannii), tigecycline (15µg only for A. baumannii) and doxycycline (30µg only for A. baumannii), all procured from Himedia Laboratories Pvt Ltd. For MBDT, colistin sulphate salt powder was procured from Sigma Life Science Pvt.…”

“…6 Infections with CRAB have been associated with mortality as high as 52%. 7,8 Mechanisms associated with carbapenem resistance can be plasmid mediated and chromosomal mediated. Carbapenem resistance in P. aeruginosa by chromosomal mutations is primarily due to mechanisms that alter porins, modify efflux pump activity, and derepress intrinsic β-lactamases.…”

Pharmacokinetics and Tolerability of Intravenous Sulbactam-Durlobactam with Imipenem-Cilastatin in Hospitalized Adults with Complicated Urinary Tract Infections, Including Acute Pyelonephritis

“…two-thirds of ABC infections are caused by multidrug-resistant (MDR) isolates (6)(7)(8). Serious infections caused by MDR ABC isolates are associated with high rates of morbidity (4,(9)(10)(11)(12), and the rate of mortality may range up to 50% or higher (4,(13)(14)(15).…”