Multidrug-resistantAcinetobacterInfection Mortality Rate and Length of Hospitalization

Abstract

Acinetobacter infections have increased and gained attention because of the organism’s prolonged environmental survival and propensity to develop antimicrobial drug resistance. The effect of multidrug-resistant (MDR) Acinetobacter infection on clinical outcomes has not been reported. A retrospective, matched cohort investigation was performed at 2 Baltimore hospitals to examine outcomes of patients with MDR Acinetobacter infection compared with patients with susceptible Acinetobacter infections and patients without Acinetobacter infections. Multivariable analysis controlling for severity of illness and underlying disease identified an independent association between patients with MDR Acinetobacter infection (n = 96) and increased hospital and intensive care unit length of stay compared with 91 patients with susceptible Acinetobacter infection (odds ratio [OR] 2.5, 95% confidence interval [CI] 1.2–5.2 and OR 2.1, 95% CI 1.0–4.3] respectively) and 89 uninfected patients (OR 2.5, 95% CI 1.2–5.4 and OR 4.2, 95% CI 1.5–11.6] respectively). Increased hospitalization associated with MDR Acinetobacter infection emphasizes the need for infection control strategies to prevent cross-transmission in healthcare settings.

Increasing Occurrence of Multidrug-Resistance in Acinetobacter baumannii Isolates From Four German University Hospitals, 2002–2006

“…Higher proportions of MDR in A. baumannii isolates among patients in ICUs were also found in other studies and can be explained by a more frequent use of invasive procedures like catheterisation or mechanical ventilation, a more common use of antibiotics and a higher proportion of critically ill patients compared to other ward types [12].…”

Prevalence and diversity of carbapenemases among imipenem-nonsusceptible Acinetobacter isolates in Korea: emergence of a novel OXA-182

“…A high colistin resistance rate of 30.6% among A. baumannii isolates from 2 Korean hospitals (Ko et al, 2007) indicated necessity of colistin susceptibility testing in other settings. With a recent increase of multiresistant Acinetobacter isolates in many countries, selection of appropriate antimicrobial agents has become very difficult, resulting in increased patient mortality (Munoz-Price and Weinstein, 2008;Sunenshine et al, 2007).…”

Molecular characterization of carbapenem-resistant Acinetobacter species in an Irish university hospital: predominance of Acinetobacter genomic species 3

“…There are now mounting data to suggest that the presence of Acinetobacter can contribute adversely to the prognosis of patients, especially in the presence of significant comorbidities (Grupper et al, 2007;Murray & Hospenthal, 2008), and multidrug resistance in such isolates is associated with increased mortality and prolonged hospitalization (Lee et al, 2007;Sunenshine et al, 2007). Furthermore, since carbapenems are frequently used for the treatment of such multidrug-resistant Acinetobacter infections, carbapenem resistance can further contribute to mortality as a result of discordant empirical therapy (Kwon et al, 2007).…”

“…have become major pathogens in hospital-associated infections, especially in critical care settings such as intensive care units (ICUs) and units for patients with severe burns (Murray & Hospenthal, 2008;Sunenshine et al, 2007). They can survive in the hospital environment for long periods and have a remarkable propensity to develop resistance to multiple classes of antimicrobial agents.…”