Clinical characteristics and outcomes of community and hospital-acquired Acinetobacter baumannii bacteremia
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 classif...
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| Format: | Article |
| Language: | English |
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Elsevier
2019-10-01
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| Series: | Journal of Microbiology, Immunology and Infection |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1684118218301889 |
| _version_ | 1818453610330062848 |
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| author | Sarunyou Chusri Virasakdi Chongsuvivatwong Kachornsakdi Silpapojakul Kamonnut Singkhamanan Thanaporn Hortiwakul Boonsri Charernmak Yohei Doi |
| author_facet | Sarunyou Chusri Virasakdi Chongsuvivatwong Kachornsakdi Silpapojakul Kamonnut Singkhamanan Thanaporn Hortiwakul Boonsri Charernmak Yohei Doi |
| author_sort | Sarunyou Chusri |
| collection | DOAJ |
| description | 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. Keywords: Acinetobacter baumannii, Community-acquired, Galleria mellonella, Outcomes |
| first_indexed | 2024-12-14T21:41:43Z |
| format | Article |
| id | doaj.art-275e1bb0749f4110ac18e561eeec0744 |
| institution | Directory Open Access Journal |
| issn | 1684-1182 |
| language | English |
| last_indexed | 2024-12-14T21:41:43Z |
| publishDate | 2019-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Microbiology, Immunology and Infection |
| spelling | doaj.art-275e1bb0749f4110ac18e561eeec07442022-12-21T22:46:26ZengElsevierJournal of Microbiology, Immunology and Infection1684-11822019-10-01525796806Clinical characteristics and outcomes of community and hospital-acquired Acinetobacter baumannii bacteremiaSarunyou Chusri0Virasakdi Chongsuvivatwong1Kachornsakdi Silpapojakul2Kamonnut Singkhamanan3Thanaporn Hortiwakul4Boonsri Charernmak5Yohei Doi6Division of Infectious Disease, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand; Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand; Department of Biomedical Sciences, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand; Corresponding author. Division of Infectious Disease, Faculty of Medicine, Prince of Songkla University, Songkhla, 90110, Thailand. Fax: +66 74 281457.Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Songkhla, ThailandDivision of Infectious Disease, Faculty of Medicine, Prince of Songkla University, Songkhla, ThailandDepartment of Biomedical Sciences, Faculty of Medicine, Prince of Songkla University, Songkhla, ThailandDivision of Infectious Disease, Faculty of Medicine, Prince of Songkla University, Songkhla, ThailandDivision of Infectious Disease, Faculty of Medicine, Prince of Songkla University, Songkhla, ThailandDivision of Infectious Diseases, University of Pittsburgh School of Medicine, Pittsburgh, PA, USAPurpose: 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. Keywords: Acinetobacter baumannii, Community-acquired, Galleria mellonella, Outcomeshttp://www.sciencedirect.com/science/article/pii/S1684118218301889 |
| spellingShingle | Sarunyou Chusri Virasakdi Chongsuvivatwong Kachornsakdi Silpapojakul Kamonnut Singkhamanan Thanaporn Hortiwakul Boonsri Charernmak Yohei Doi Clinical characteristics and outcomes of community and hospital-acquired Acinetobacter baumannii bacteremia Journal of Microbiology, Immunology and Infection |
| title | Clinical characteristics and outcomes of community and hospital-acquired Acinetobacter baumannii bacteremia |
| title_full | Clinical characteristics and outcomes of community and hospital-acquired Acinetobacter baumannii bacteremia |
| title_fullStr | Clinical characteristics and outcomes of community and hospital-acquired Acinetobacter baumannii bacteremia |
| title_full_unstemmed | Clinical characteristics and outcomes of community and hospital-acquired Acinetobacter baumannii bacteremia |
| title_short | Clinical characteristics and outcomes of community and hospital-acquired Acinetobacter baumannii bacteremia |
| title_sort | clinical characteristics and outcomes of community and hospital acquired acinetobacter baumannii bacteremia |
| url | http://www.sciencedirect.com/science/article/pii/S1684118218301889 |
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