The association between Acinetobacter baumannii infections and the COVID-19 pandemic in an intensive care unit

Abstract

We aimed to describe the increased rate of Acinetobacter baumannii infections during the COVID-19 pandemic and define its significance within the last five years. This study was performed in a tertiary hospital with 280 beds and included all patients infected with A. baumannii in the intensive care unit between January 1, 2018, and June 30, 2022. A. baumannii-infected patients in the intensive care unit 27 months before the pandemic and 27 months during the pandemic were included. Pulsed-field gel electrophoresis was performed to assess clonal relatedness. The infection control measures were specified based on the findings and targeted elimination. In total, 5718 patients were admitted to the intensive care unit from January 1st, 2018, to June 30th, 2022. A. baumannii infection was detected in 81 patients. Compared to the pre-pandemic era, the rate of A. baumannii infection during the pandemic was 1.90 times higher (OR: 1.90, 95% CI: [1.197, 3.033]). Clonality assessment of multidrug-resistant A. baumannii samples revealed eight clusters with one main cluster comprising 14/27 isolates between 2021 and 2022. The case fatality rate of the pre-pandemic and pandemic era was not different statistically (83.33% vs. 81.48%, p = 0.835). Univariate analysis revealed the association of mechanical ventilation (p = 0.002) and bacterial growth in tracheal aspirate (p = 0.001) with fatality. During the COVID-19 pandemic, potential deficits in infection control measures may lead to persistent nosocomial outbreaks. In this study, the introduction of enhanced and customized infection control measures has resulted in the containment of an A. baumannii outbreak.

Carbapenem-resistant Acinetobacter baumannii in Latin America

“…An increased risk of CRAb infections in patients with an increased risk of mortality due to COVID-19 infections was reported. This increased incidences of A. baumannii infections during the COVID-19 pandemic were related to various reasons such as prolonged hospital stay, mechanical ventilation, and immunosuppression [61].…”

Phylogenomic and phenotypic analyses highlight the diversity of antibiotic resistance and virulence in both human and non-human Acinetobacter baumannii

“…Additionally, carbapenem-resistant A. baumannii has been labeled a priority 1 pathogen by the World Health Organization ( 4 ) due to the inability to cure such infections. Due to the COVID-19 pandemic, the number of A. baumannii infections increased ( 5 ), and there is a high frequency of multi-drug resistance (MDR), upwards of 70% of strains ( 1 ). The presence of antibiotic resistance genes (ARGs) and virulence genes (VGs) is characteristic of A. baumannii genomes.…”

A novel strategy to characterize the pattern of β-lactam antibiotic-induced drug resistance in Acinetobacter baumannii

“…Acinetobacter baumannii (Ab), an aerobic Gram-negative coccobacillus, is one of the ESKAPE pathogens and is currently classified as an urgent threat to public health by the CDC 1 . This classification is due to the severity and high mortality (in some cases greater than 50%) of carbapenem-resistant Ab (CRAb) infections 2 – 8 . Additionally, these infections are generally nosocomial and frequently occur in the intensive care unit (ICU; accounting in some cases for up to 31% of ICU infections around the world) where patients are already more sensitive 2 , 9 – 12 .…”