Clinical outcomes of carbapenem-resistant Acinetobacter baumannii bloodstream infections: Study of a 2-state monoclonal outbreak

L. Silvia Munoz-Price, Teresa Zembower, Sudhir Penugonda, Paul Schreckenberger, Mary Alice Lavin, Sharon Welbel, Dana Vais, Mirza Baig, Sunita Mohapatra, John P. Quinn, Robert A. Weinstein

Research output: Contribution to journalArticle

54 Scopus citations

Abstract

OBJECTIVE. To characterize the clinical outcomes of patients with bloodstream infection caused by carbapenem-resistant Acinetobacter baumannii during a 2-state monoclonal outbreak. DESIGN. Multicenter observational study. SETTING. Four tertiary care hospitals and 1 long-term acute care hospital. METHODS. A retrospective medical chart review was conducted for all consecutive patients during the period January 1, 2005, through April 30, 2006, for whom 1 or more blood cultures yielded carbapenem-resistant A. baumannii. RESULTS. We identified 86 patients from the 16-month study period. Their mortality rate was 41%; of the 35 patients who died, one-third (13) had positive blood culture results for carbapenem-resistant A. baumannii at the time of death. Risk factors associated with mortality were intensive care unit stay, malignancy, and presence of fever and/or hypotension at the time blood sample for culture was obtained. Only 5 patients received adequate empirical antibiotic treatment, but the choice of treatment did not affect mortality. Fifty-seven patients (66.2%) had a single positive blood culture result for carbapenem-resistant A. baumannii; the only factor associated with a single positive blood culture result was the presence of decubitus ulcers. Interestingly, during the study period, a transition from single to multiple positive blood culture results was observed. Four patients, 3 of whom were in a burn intensive care unit, were bacteremic for more than 30 days (range, 36-86 days). CONCLUSIONS. To our knowledge, this is the first time a study has described 2 patterns of bloodstream infection with A. baumannii: single versus multiple positive blood culture results, as well as a subset of patients with prolonged bacteremia.

Original languageEnglish (US)
Pages (from-to)1057-1062
Number of pages6
JournalInfection control and hospital epidemiology
Volume31
Issue number10
DOIs
StatePublished - Oct 2010

ASJC Scopus subject areas

  • Epidemiology
  • Microbiology (medical)
  • Infectious Diseases

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    Munoz-Price, L. S., Zembower, T., Penugonda, S., Schreckenberger, P., Lavin, M. A., Welbel, S., Vais, D., Baig, M., Mohapatra, S., Quinn, J. P., & Weinstein, R. A. (2010). Clinical outcomes of carbapenem-resistant Acinetobacter baumannii bloodstream infections: Study of a 2-state monoclonal outbreak. Infection control and hospital epidemiology, 31(10), 1057-1062. https://doi.org/10.1086/656247