Clinical characteristics and outcomes of community and hospital-acquired Acinetobacter baumannii bacteremia

Sarunyou Chusri, Virasakdi Chongsuvivatwong, Kachornsakdi Silpapojakul, Kamonnut Singkhamanan, Thanaporn Hortiwakul, Boonsri Charernmak, Yohei Doi

Research output: Contribution to journalArticle

Abstract

Purpose: We aimed to characterize clinical manifestations of the patients with bacteremia due to community-acquired Acinetobacter baumannii and evaluate the outcomes of these patients. Methods: We conducted a retrospective study to include adult patients with A. baumannii bacteremia and then classified them into two groups: community-acquired A. baumannii bacteremia and hospital-acquired A. baumannii bacteremia. Characteristics and outcomes between 2 groups were compared. The Galleria mellonella infection survival model was used to determine the virulence of A. baumannii in these 2 groups. Results: There were 63 patients with A. baumannii bacteremia: 21 patients with community-acquired (CA) bacteremia and 42 patients with hospital-acquired (HA) bacteremia. Three patients with CA bacteremia were excluded due to healthcare-associated risks of infection. The remaining 18 patients with CA bacteremia had carbapenem-susceptible A. baumannii (CA-CSAB). Among the 42 patients with HA bacteremia, 11 patients had carbapenem-susceptible A. baumannii (HA-CSAB) and 31 patients had carbapenem-resistant A. baumannii (HA-CRAB). The 30-day mortality rates of those with CA-CSAB did not differ from those with HA-CSAB bacteremia but were significantly lower than those with HA-CRAB (p = 0.003). The factors influencing 30-day mortality were infection with CRAB (p = 0.004), appropriate empirical antimicrobial therapy (p = 0.002), and higher Acute Physiology and Chronic Health Evaluation II score (p < 0.001). The G. mellonella assay showed no differences in survival rates among CA-CSAB, HA-CSAB, and HA-CRAB. Conclusions: Patients with bacteremia due to CA-CSAB and HA-CSAB had similar outcomes. Similar virulences of CA-CSAB and HA-CSAB were confirmed with the G. mellonella infection model.

Original languageEnglish
Pages (from-to)796-806
Number of pages11
JournalJournal of Microbiology, Immunology and Infection
Volume52
Issue number5
DOIs
Publication statusPublished - 01-10-2019

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Acinetobacter baumannii
Community Hospital
Bacteremia
Carbapenems
Virulence
Infection
APACHE
Mortality
Cross Infection
Survival Rate
Retrospective Studies

All Science Journal Classification (ASJC) codes

  • Immunology and Allergy
  • Immunology and Microbiology(all)
  • Microbiology (medical)
  • Infectious Diseases

Cite this

Chusri, Sarunyou ; Chongsuvivatwong, Virasakdi ; Silpapojakul, Kachornsakdi ; Singkhamanan, Kamonnut ; Hortiwakul, Thanaporn ; Charernmak, Boonsri ; Doi, Yohei. / Clinical characteristics and outcomes of community and hospital-acquired Acinetobacter baumannii bacteremia. In: Journal of Microbiology, Immunology and Infection. 2019 ; Vol. 52, No. 5. pp. 796-806.
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Clinical characteristics and outcomes of community and hospital-acquired Acinetobacter baumannii bacteremia. / Chusri, Sarunyou; Chongsuvivatwong, Virasakdi; Silpapojakul, Kachornsakdi; Singkhamanan, Kamonnut; Hortiwakul, Thanaporn; Charernmak, Boonsri; Doi, Yohei.

In: Journal of Microbiology, Immunology and Infection, Vol. 52, No. 5, 01.10.2019, p. 796-806.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Clinical characteristics and outcomes of community and hospital-acquired Acinetobacter baumannii bacteremia

AU - Chusri, Sarunyou

AU - Chongsuvivatwong, Virasakdi

AU - Silpapojakul, Kachornsakdi

AU - Singkhamanan, Kamonnut

AU - Hortiwakul, Thanaporn

AU - Charernmak, Boonsri

AU - Doi, Yohei

PY - 2019/10/1

Y1 - 2019/10/1

N2 - Purpose: We aimed to characterize clinical manifestations of the patients with bacteremia due to community-acquired Acinetobacter baumannii and evaluate the outcomes of these patients. Methods: We conducted a retrospective study to include adult patients with A. baumannii bacteremia and then classified them into two groups: community-acquired A. baumannii bacteremia and hospital-acquired A. baumannii bacteremia. Characteristics and outcomes between 2 groups were compared. The Galleria mellonella infection survival model was used to determine the virulence of A. baumannii in these 2 groups. Results: There were 63 patients with A. baumannii bacteremia: 21 patients with community-acquired (CA) bacteremia and 42 patients with hospital-acquired (HA) bacteremia. Three patients with CA bacteremia were excluded due to healthcare-associated risks of infection. The remaining 18 patients with CA bacteremia had carbapenem-susceptible A. baumannii (CA-CSAB). Among the 42 patients with HA bacteremia, 11 patients had carbapenem-susceptible A. baumannii (HA-CSAB) and 31 patients had carbapenem-resistant A. baumannii (HA-CRAB). The 30-day mortality rates of those with CA-CSAB did not differ from those with HA-CSAB bacteremia but were significantly lower than those with HA-CRAB (p = 0.003). The factors influencing 30-day mortality were infection with CRAB (p = 0.004), appropriate empirical antimicrobial therapy (p = 0.002), and higher Acute Physiology and Chronic Health Evaluation II score (p < 0.001). The G. mellonella assay showed no differences in survival rates among CA-CSAB, HA-CSAB, and HA-CRAB. Conclusions: Patients with bacteremia due to CA-CSAB and HA-CSAB had similar outcomes. Similar virulences of CA-CSAB and HA-CSAB were confirmed with the G. mellonella infection model.

AB - Purpose: We aimed to characterize clinical manifestations of the patients with bacteremia due to community-acquired Acinetobacter baumannii and evaluate the outcomes of these patients. Methods: We conducted a retrospective study to include adult patients with A. baumannii bacteremia and then classified them into two groups: community-acquired A. baumannii bacteremia and hospital-acquired A. baumannii bacteremia. Characteristics and outcomes between 2 groups were compared. The Galleria mellonella infection survival model was used to determine the virulence of A. baumannii in these 2 groups. Results: There were 63 patients with A. baumannii bacteremia: 21 patients with community-acquired (CA) bacteremia and 42 patients with hospital-acquired (HA) bacteremia. Three patients with CA bacteremia were excluded due to healthcare-associated risks of infection. The remaining 18 patients with CA bacteremia had carbapenem-susceptible A. baumannii (CA-CSAB). Among the 42 patients with HA bacteremia, 11 patients had carbapenem-susceptible A. baumannii (HA-CSAB) and 31 patients had carbapenem-resistant A. baumannii (HA-CRAB). The 30-day mortality rates of those with CA-CSAB did not differ from those with HA-CSAB bacteremia but were significantly lower than those with HA-CRAB (p = 0.003). The factors influencing 30-day mortality were infection with CRAB (p = 0.004), appropriate empirical antimicrobial therapy (p = 0.002), and higher Acute Physiology and Chronic Health Evaluation II score (p < 0.001). The G. mellonella assay showed no differences in survival rates among CA-CSAB, HA-CSAB, and HA-CRAB. Conclusions: Patients with bacteremia due to CA-CSAB and HA-CSAB had similar outcomes. Similar virulences of CA-CSAB and HA-CSAB were confirmed with the G. mellonella infection model.

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