Abstract
Background. We aimed to determine the effect of the presence of carbapenem-resistant Acinetobacter baumannii in accordance with surveillance cultures on the subsequent development of clinical infections by this organism. Methods. This retrospective cohort study was conducted at a tertiary hospital from January 2010 to November 2011. We included all consecutive patients admitted to the trauma intensive care unit, who had weekly surveillance cultures performed (from rectum, and if intubated, respiratory secretions), and without evidence of A. baumannii infections prior to the collection of the first surveillance culture. Univariable and multivariable analyses were performed using log-binomial regression. Survival analyses were performed using Cox proportional hazards. Results. Three hundred sixty-four patients were included, of whom 49 (13.5%) had carbapenem-resistant A. baumannii on surveillance cultures. Patients with positive surveillance cultures had 8.4 (95% confidence interval [CI], 5.6-12.7; P <. 0001) times the risk of developing a subsequent A. baumannii infection compared with patients who remained negative on surveillance cultures. Multivariable analysis showed significant associations between clinical infection and both positive surveillance cultures (relative risk [RR], 5.9 [95% CI, 3.8-9.3]; P <. 0001) and mechanical ventilation (RR, 4.3 [95% CI, 1.03-18.2]; P =. 05). On survival analyses, the only variable associated with the development of clinical infections was the presence of positive surveillance cultures (hazard ratio, 16.3 [95% CI, 9.1-29.1]; P <. 001). Conclusions. Presence of carbapenem-resistant A. baumannii on surveillance cultures is strongly associated with subsequent development of carbapenem-resistant A. baumannii infections. Prevention efforts should be focused at limiting the acquisition of this organism during hospitalization.
| Original language | English |
|---|---|
| Pages (from-to) | 415-422 |
| Number of pages | 8 |
| Journal | Clinical Infectious Diseases |
| Volume | 60 |
| Issue number | 3 |
| DOIs | |
| State | Published - Feb 1 2015 |
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Keywords
- Acinetobacter baumannii
- carbapenem-resistant
- clinical infections
- intensive care unit
- surveillance cultures
ASJC Scopus subject areas
- Infectious Diseases
- Microbiology (medical)
Cite this
Surveillance cultures growing carbapenem-resistant acinetobacter baumannii predict the development of clinical infections : A retrospective cohort study. / Latibeaudiere, Rachel; Rosa, Rossana; Laowansiri, Panthipa; Arheart, Kristopher; Namias, Nicholas; Munoz-Price, Luisa.
In: Clinical Infectious Diseases, Vol. 60, No. 3, 01.02.2015, p. 415-422.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Surveillance cultures growing carbapenem-resistant acinetobacter baumannii predict the development of clinical infections
T2 - A retrospective cohort study
AU - Latibeaudiere, Rachel
AU - Rosa, Rossana
AU - Laowansiri, Panthipa
AU - Arheart, Kristopher
AU - Namias, Nicholas
AU - Munoz-Price, Luisa
PY - 2015/2/1
Y1 - 2015/2/1
N2 - Background. We aimed to determine the effect of the presence of carbapenem-resistant Acinetobacter baumannii in accordance with surveillance cultures on the subsequent development of clinical infections by this organism. Methods. This retrospective cohort study was conducted at a tertiary hospital from January 2010 to November 2011. We included all consecutive patients admitted to the trauma intensive care unit, who had weekly surveillance cultures performed (from rectum, and if intubated, respiratory secretions), and without evidence of A. baumannii infections prior to the collection of the first surveillance culture. Univariable and multivariable analyses were performed using log-binomial regression. Survival analyses were performed using Cox proportional hazards. Results. Three hundred sixty-four patients were included, of whom 49 (13.5%) had carbapenem-resistant A. baumannii on surveillance cultures. Patients with positive surveillance cultures had 8.4 (95% confidence interval [CI], 5.6-12.7; P <. 0001) times the risk of developing a subsequent A. baumannii infection compared with patients who remained negative on surveillance cultures. Multivariable analysis showed significant associations between clinical infection and both positive surveillance cultures (relative risk [RR], 5.9 [95% CI, 3.8-9.3]; P <. 0001) and mechanical ventilation (RR, 4.3 [95% CI, 1.03-18.2]; P =. 05). On survival analyses, the only variable associated with the development of clinical infections was the presence of positive surveillance cultures (hazard ratio, 16.3 [95% CI, 9.1-29.1]; P <. 001). Conclusions. Presence of carbapenem-resistant A. baumannii on surveillance cultures is strongly associated with subsequent development of carbapenem-resistant A. baumannii infections. Prevention efforts should be focused at limiting the acquisition of this organism during hospitalization.
AB - Background. We aimed to determine the effect of the presence of carbapenem-resistant Acinetobacter baumannii in accordance with surveillance cultures on the subsequent development of clinical infections by this organism. Methods. This retrospective cohort study was conducted at a tertiary hospital from January 2010 to November 2011. We included all consecutive patients admitted to the trauma intensive care unit, who had weekly surveillance cultures performed (from rectum, and if intubated, respiratory secretions), and without evidence of A. baumannii infections prior to the collection of the first surveillance culture. Univariable and multivariable analyses were performed using log-binomial regression. Survival analyses were performed using Cox proportional hazards. Results. Three hundred sixty-four patients were included, of whom 49 (13.5%) had carbapenem-resistant A. baumannii on surveillance cultures. Patients with positive surveillance cultures had 8.4 (95% confidence interval [CI], 5.6-12.7; P <. 0001) times the risk of developing a subsequent A. baumannii infection compared with patients who remained negative on surveillance cultures. Multivariable analysis showed significant associations between clinical infection and both positive surveillance cultures (relative risk [RR], 5.9 [95% CI, 3.8-9.3]; P <. 0001) and mechanical ventilation (RR, 4.3 [95% CI, 1.03-18.2]; P =. 05). On survival analyses, the only variable associated with the development of clinical infections was the presence of positive surveillance cultures (hazard ratio, 16.3 [95% CI, 9.1-29.1]; P <. 001). Conclusions. Presence of carbapenem-resistant A. baumannii on surveillance cultures is strongly associated with subsequent development of carbapenem-resistant A. baumannii infections. Prevention efforts should be focused at limiting the acquisition of this organism during hospitalization.
KW - Acinetobacter baumannii
KW - carbapenem-resistant
KW - clinical infections
KW - intensive care unit
KW - surveillance cultures
UR - http://www.scopus.com/inward/record.url?scp=84922463853&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84922463853&partnerID=8YFLogxK
U2 - 10.1093/cid/ciu847
DO - 10.1093/cid/ciu847
M3 - Article
C2 - 25352586
AN - SCOPUS:84922463853
VL - 60
SP - 415
EP - 422
JO - Clinical Infectious Diseases
JF - Clinical Infectious Diseases
SN - 1058-4838
IS - 3
ER -