TY - JOUR
T1 - Influence of ACB complex genospecies on clinical outcomes in a U.S. hospital with high rates of multidrug resistance
AU - Fitzpatrick, Margaret A.
AU - Ozer, Egon
AU - Bolon, Maureen K.
AU - Hauser, Alan R.
N1 - Funding Information:
This work was supported by the National Institutes of Health ( T32 AI095207 , AI053674 , AI075191 , AI099269 , AI04831 and AI088286 ) and by an Eleanor-Wood Prince intramural grant from Northwestern Memorial Hospital. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Publisher Copyright:
© 2014 The British Infection Association.
PY - 2015/2/1
Y1 - 2015/2/1
N2 - Objectives: Bacteria within the Acinetobacter calcoaceticus-Acinetobacter baumannii (ACB) complex commonly cause nosocomial infection and are often multidrug resistant. Advances in genospecies typing allow for speciation within the ACB complex; however, little is known about the effect of genospecies on patient outcomes. Methods: Adult patients with ACB complex bacteremia from Jan 2005-Oct 2012 were included. Bacterial isolates were speciated by rpoB gene sequence analysis, and clinical data were collected. Results: Of 147 patients with ACB complex bacteremia, 116 had A. baumannii (78.9%), 28 had Acinetobacter pittii (19.0%), and 3 had Acinetobacter nosocomialis (2.0%). A. baumannii bacteremia was associated with greater comorbidity and was more frequently multidrug resistant (79% vs. 16%, p<0.01). Multidrug resistant A. baumannii but not susceptible A. baumannii was associated with worse outcomes compared to non-. baumannii ACB complex bacteremia. Neither multidrug resistance nor genospecies was an independent predictor of mortality, but receipt of appropriate therapy was associated with decreased risk of mortality (OR, 0.13; 95% CI, 0.04-0.44; p<0.01). Conclusions: A. baumannii bacteremia is associated with worse clinical outcomes than non-. baumannii ACB complex bacteremia. The difference, however, appears to be related to multidrug resistance and attendant receipt of appropriate therapy rather than genospecies.
AB - Objectives: Bacteria within the Acinetobacter calcoaceticus-Acinetobacter baumannii (ACB) complex commonly cause nosocomial infection and are often multidrug resistant. Advances in genospecies typing allow for speciation within the ACB complex; however, little is known about the effect of genospecies on patient outcomes. Methods: Adult patients with ACB complex bacteremia from Jan 2005-Oct 2012 were included. Bacterial isolates were speciated by rpoB gene sequence analysis, and clinical data were collected. Results: Of 147 patients with ACB complex bacteremia, 116 had A. baumannii (78.9%), 28 had Acinetobacter pittii (19.0%), and 3 had Acinetobacter nosocomialis (2.0%). A. baumannii bacteremia was associated with greater comorbidity and was more frequently multidrug resistant (79% vs. 16%, p<0.01). Multidrug resistant A. baumannii but not susceptible A. baumannii was associated with worse outcomes compared to non-. baumannii ACB complex bacteremia. Neither multidrug resistance nor genospecies was an independent predictor of mortality, but receipt of appropriate therapy was associated with decreased risk of mortality (OR, 0.13; 95% CI, 0.04-0.44; p<0.01). Conclusions: A. baumannii bacteremia is associated with worse clinical outcomes than non-. baumannii ACB complex bacteremia. The difference, however, appears to be related to multidrug resistance and attendant receipt of appropriate therapy rather than genospecies.
KW - Acinetobacter baumannii
KW - Acinetobacter calcoaceticus
KW - Bacteremia
KW - Genome
KW - Multidrug resistance
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U2 - 10.1016/j.jinf.2014.09.004
DO - 10.1016/j.jinf.2014.09.004
M3 - Article
C2 - 25246361
AN - SCOPUS:84921293484
SN - 0163-4453
VL - 70
SP - 144
EP - 152
JO - Journal of Infection
JF - Journal of Infection
IS - 2
ER -
