Multidrug-resistant Acinetobacter: Risk factors and outcomes in veterans with spinal cord injuries and disorders

Swetha Ramanathan*, Katie J. Suda, Margaret A. Fitzpatrick, Linda Poggensee, Sherri L. LaVela, Stephen P. Burns, Charlesnika T. Evans

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

10 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1183-1189
Number of pages7
JournalAmerican Journal of Infection Control
Volume45
Issue number11
DOIs
StatePublished - Nov 1 2017

Keywords

  • 30-day mortality
  • Acinetobacter
  • Epidemiology
  • Multidrug resistance
  • Risk factors
  • Spinal cord injury
  • Veterans Affairs

ASJC Scopus subject areas

  • Epidemiology
  • Health Policy
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

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