Association of capsular types with carbapenem resistance, disease severity, and mortality in Acinetobacter baumannii
ABSTRACTAcinetobacter baumannii emerged as one of the most important pathogens that causes nosocomial infections due to its increased multidrug resistance. Identifying capsular epidemiology in A. baumannii can aid in the development of effective treatments and preventive measures against this emergi...
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2020-01-01
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| Series: | Emerging Microbes and Infections |
| Subjects: | |
| Online Access: | https://www.tandfonline.com/doi/10.1080/22221751.2020.1822757 |
| _version_ | 1827320728625610752 |
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| author | Yu-Chia Hsieh Shi-Heng Wang Yi-Yin Chen Tzu-Lung Lin Shian-Sen Shie Ching-Tai Huang Chen-Hsiang Lee Yi-Ching Chen Tran Lam Tu Quyen Yi-Jiun Pan |
| author_facet | Yu-Chia Hsieh Shi-Heng Wang Yi-Yin Chen Tzu-Lung Lin Shian-Sen Shie Ching-Tai Huang Chen-Hsiang Lee Yi-Ching Chen Tran Lam Tu Quyen Yi-Jiun Pan |
| author_sort | Yu-Chia Hsieh |
| collection | DOAJ |
| description | ABSTRACTAcinetobacter baumannii emerged as one of the most important pathogens that causes nosocomial infections due to its increased multidrug resistance. Identifying capsular epidemiology in A. baumannii can aid in the development of effective treatments and preventive measures against this emerging pathogen. Here we established a wzc-based method, and combined it with wzy-PCR to determine capsular types of A. baumannii causing nosocomial bacteraemia collected at two medical centres in Taiwan from 2015 to 2017. Among the 237 patients with A. baumannii bacteraemia, 98 (41.4%) isolates were resistant to carbapenems. Four prevalent capsular types (KL2, KL10, KL22, and KL52) accounted for 84.7% of carbapenem-resistant A. baumannii (CRAB) and 12.2% of non-CRAB. The rate of pneumonia, intensive care unit admission, APACHE II score, and Pitt bacteraemia score were higher in patients with KL2/10/22/52 infection than in those with non-KL2/10/22/52 infection. Patients with KL2/10/22/52 infection and patients with CRAB infection have a higher cumulative incidence of attributable and all-cause in-hospital 30-day mortality. On multivariate analysis, appropriate empirical antimicrobial therapy within 24 h was associated with a lower risk of 30-day attributable mortality in the KL2/10/22/52 isolates (odds ratio = 0.19, 95% CI: 0.06–0.66, p = 0.008) but not in non-KL2/10/22/52 isolates. Early recognition of carbapenem resistance-associated capsular types may help clinicians to promptly implement appropriate antimicrobial therapy for improving the outcomes in patients with CRAB bacteraemia. |
| first_indexed | 2024-03-07T17:24:36Z |
| format | Article |
| id | doaj.art-e83b9d99cd0041ec8a11b1b878ce07b4 |
| institution | Directory Open Access Journal |
| issn | 2222-1751 |
| language | English |
| last_indexed | 2024-04-25T00:52:15Z |
| publishDate | 2020-01-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Emerging Microbes and Infections |
| spelling | doaj.art-e83b9d99cd0041ec8a11b1b878ce07b42024-03-11T16:04:23ZengTaylor & Francis GroupEmerging Microbes and Infections2222-17512020-01-01912094210410.1080/22221751.2020.1822757Association of capsular types with carbapenem resistance, disease severity, and mortality in Acinetobacter baumanniiYu-Chia Hsieh0Shi-Heng Wang1Yi-Yin Chen2Tzu-Lung Lin3Shian-Sen Shie4Ching-Tai Huang5Chen-Hsiang Lee6Yi-Ching Chen7Tran Lam Tu Quyen8Yi-Jiun Pan9Department of Pediatrics, Chang Gung Children’s Hospital, Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, Taoyuan, TaiwanDepartment of Occupational Safety and Health and Public Health, College of Public Health, China Medical University, Taichung, TaiwanDepartment of Pediatrics, Chang Gung Children’s Hospital, Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, Taoyuan, TaiwanDepartment of Medical Biotechnology and Laboratory Science, Chang Gung University, Taoyuan, TaiwanDivision of Infectious Diseases, Department of Internal Medicine, Chang Gung Memorial Hospital, Taipei, Taoyuan, TaiwanDivision of Infectious Diseases, Department of Internal Medicine, Chang Gung Memorial Hospital, Taipei, Taoyuan, TaiwanDivision of Infectious Diseases, Department of Internal Medicine, Chang Gung Memorial Hospital – Kaohsiung Medical Center, Chang Gung University, Kaohsiung, TaiwanDepartment of Pediatrics, Chang Gung Children’s Hospital, Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, Taoyuan, TaiwanDepartment of Microbiology and Immunology, School of Medicine, College of Medicine, China Medical University, Taichung, TaiwanDepartment of Microbiology and Immunology, School of Medicine, College of Medicine, China Medical University, Taichung, TaiwanABSTRACTAcinetobacter baumannii emerged as one of the most important pathogens that causes nosocomial infections due to its increased multidrug resistance. Identifying capsular epidemiology in A. baumannii can aid in the development of effective treatments and preventive measures against this emerging pathogen. Here we established a wzc-based method, and combined it with wzy-PCR to determine capsular types of A. baumannii causing nosocomial bacteraemia collected at two medical centres in Taiwan from 2015 to 2017. Among the 237 patients with A. baumannii bacteraemia, 98 (41.4%) isolates were resistant to carbapenems. Four prevalent capsular types (KL2, KL10, KL22, and KL52) accounted for 84.7% of carbapenem-resistant A. baumannii (CRAB) and 12.2% of non-CRAB. The rate of pneumonia, intensive care unit admission, APACHE II score, and Pitt bacteraemia score were higher in patients with KL2/10/22/52 infection than in those with non-KL2/10/22/52 infection. Patients with KL2/10/22/52 infection and patients with CRAB infection have a higher cumulative incidence of attributable and all-cause in-hospital 30-day mortality. On multivariate analysis, appropriate empirical antimicrobial therapy within 24 h was associated with a lower risk of 30-day attributable mortality in the KL2/10/22/52 isolates (odds ratio = 0.19, 95% CI: 0.06–0.66, p = 0.008) but not in non-KL2/10/22/52 isolates. Early recognition of carbapenem resistance-associated capsular types may help clinicians to promptly implement appropriate antimicrobial therapy for improving the outcomes in patients with CRAB bacteraemia.https://www.tandfonline.com/doi/10.1080/22221751.2020.1822757Acinetobacter baumanniicapsular typeserotypetyping systemcarbapenem resistance |
| spellingShingle | Yu-Chia Hsieh Shi-Heng Wang Yi-Yin Chen Tzu-Lung Lin Shian-Sen Shie Ching-Tai Huang Chen-Hsiang Lee Yi-Ching Chen Tran Lam Tu Quyen Yi-Jiun Pan Association of capsular types with carbapenem resistance, disease severity, and mortality in Acinetobacter baumannii Emerging Microbes and Infections Acinetobacter baumannii capsular type serotype typing system carbapenem resistance |
| title | Association of capsular types with carbapenem resistance, disease severity, and mortality in Acinetobacter baumannii |
| title_full | Association of capsular types with carbapenem resistance, disease severity, and mortality in Acinetobacter baumannii |
| title_fullStr | Association of capsular types with carbapenem resistance, disease severity, and mortality in Acinetobacter baumannii |
| title_full_unstemmed | Association of capsular types with carbapenem resistance, disease severity, and mortality in Acinetobacter baumannii |
| title_short | Association of capsular types with carbapenem resistance, disease severity, and mortality in Acinetobacter baumannii |
| title_sort | association of capsular types with carbapenem resistance disease severity and mortality in acinetobacter baumannii |
| topic | Acinetobacter baumannii capsular type serotype typing system carbapenem resistance |
| url | https://www.tandfonline.com/doi/10.1080/22221751.2020.1822757 |
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