TY - JOUR
T1 - Multidrug-resistant Acinetobacter
T2 - Risk factors and outcomes in veterans with spinal cord injuries and disorders
AU - Ramanathan, Swetha
AU - Suda, Katie J.
AU - Fitzpatrick, Margaret A.
AU - Poggensee, Linda
AU - LaVela, Sherri L.
AU - Burns, Stephen P.
AU - Evans, Charlesnika T.
N1 - Funding Information:
Funding/support: Supported by the Department of Veterans Affairs, Veterans Health Administration, Office of Research and Development, Rehabilitation Research and Development Service Merit Review Award (grant no. B-1583-P).
Publisher Copyright:
© 2017
PY - 2017/11/1
Y1 - 2017/11/1
N2 - Background Multidrug-resistant (MDR) Acinetobacter is a growing concern and has been identified as a serious threat by the Centers for Disease Control and Prevention. However, there is little information on MDR Acinetobacter in individuals with spinal cord injuries and disorders (SCI/Ds). Therefore, the objective of this study was to identify risk factors for, and assess outcomes of, MDR Acinetobacter in veterans with SCI/Ds. Methods This was a retrospective cohort study from January 1, 2012-December 31, 2013, using national Veterans Affairs medical encounter and microbiology data. Results A total of 773 Acinetobacter cultures were identified in 571 patients, of which 58.9% were MDR. Inpatient culture, sputum and other specimen type, receipt of antibiotics within 90 days before culture date, and pressure ulcers were identified as independent predictors of MDR Acinetobacter. Highest odds of MDR Acinetobacter were seen with previous antibiotic use (odds ratio, 7.27; 95% confidence interval, 2.59-20.54). Thirty-day mortality was 5.3% in this study. Multidrug resistance, previous mechanical ventilation 90 days before the culture, and cancer were all independent risk factors for 30-day mortality. Conclusions There should be increased efforts to highlight the importance of antimicrobial stewardship to improve infection control to help limit spread of Acinetobacter in health care settings.
AB - Background Multidrug-resistant (MDR) Acinetobacter is a growing concern and has been identified as a serious threat by the Centers for Disease Control and Prevention. However, there is little information on MDR Acinetobacter in individuals with spinal cord injuries and disorders (SCI/Ds). Therefore, the objective of this study was to identify risk factors for, and assess outcomes of, MDR Acinetobacter in veterans with SCI/Ds. Methods This was a retrospective cohort study from January 1, 2012-December 31, 2013, using national Veterans Affairs medical encounter and microbiology data. Results A total of 773 Acinetobacter cultures were identified in 571 patients, of which 58.9% were MDR. Inpatient culture, sputum and other specimen type, receipt of antibiotics within 90 days before culture date, and pressure ulcers were identified as independent predictors of MDR Acinetobacter. Highest odds of MDR Acinetobacter were seen with previous antibiotic use (odds ratio, 7.27; 95% confidence interval, 2.59-20.54). Thirty-day mortality was 5.3% in this study. Multidrug resistance, previous mechanical ventilation 90 days before the culture, and cancer were all independent risk factors for 30-day mortality. Conclusions There should be increased efforts to highlight the importance of antimicrobial stewardship to improve infection control to help limit spread of Acinetobacter in health care settings.
KW - 30-day mortality
KW - Acinetobacter
KW - Epidemiology
KW - Multidrug resistance
KW - Risk factors
KW - Spinal cord injury
KW - Veterans Affairs
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U2 - 10.1016/j.ajic.2017.06.016
DO - 10.1016/j.ajic.2017.06.016
M3 - Article
C2 - 28757086
AN - SCOPUS:85026296490
SN - 0196-6553
VL - 45
SP - 1183
EP - 1189
JO - American Journal of Infection Control
JF - American Journal of Infection Control
IS - 11
ER -
