Clinical Features and Antimicrobial Susceptibility of Pseudomonas aeruginosa and Acinetobacter baumannii Complex Isolates in Intensive Care Patients with Chronic Obstructive Pulmonary Disease and Community-Acquired Pneumonia in Taiwan

Abstract

Purpose Little is known about the features and implications of Pseudomonas aeruginosa (PA) and Acinetobacter baumannii complex (ABC) isolates discovered in patients with chronic obstructive pulmonary disease (COPD) and community-acquired pneumonia (CAP) requiring invasive mechanical ventilation and admission to an intensive care unit. Thus, our study aimed to investigate the clinical characteristics and antimicrobial susceptibilities of PA and ABC isolates cultured from endotracheal aspirates (EAs) in such population. Patients and Methods In this retrospective, cross-sectional study, clinical data from medical records were reviewed and collected for analysis. Results Of the 262 participants, 17.2% (45/262), 11.5% (30/262), and 27.1% (71/262) had PA, ABC, and any of the two isolates discovered from EA cultures, respectively. Patients with PA isolates were associated with poorer lung function (the Global Initiative for Chronic Obstructive Lung Disease (GOLD) III+IV versus GOLD I+II, odds ratio (OR)=2.39, p= 0.022) and a lower body mass index (per increase of 1 kg/m 2 , OR= 0.93, p= 0.106) while the former was an independent predictor. Moreover, both subjects with ABC isolates and those with any of these two microorganisms were independently associated with a lower serum albumin level (per increase of 1 g/dL, OR= 0.44, p=0.009 and OR= 0.59, p=0.023, respectively). Participants with PA isolates were more likely to have failed weaning (62.2% versus 44.7%, p= 0.048) and death (28.9% versus 12.4%, p= 0.010) than those without PA isolates. The majority of the PA and ABC isolates were susceptible and resistant to all the tested antimicrobials, respectively, except that tigecycline had a reliable activity against ABC. Conclusion Our findings provide important information to help intensivists make better treatment decisions in critically ill patients with COPD and CAP.

Nomogram Analysis of Clinical Characteristics and Mortality Risk Factor of Non-Fermentative Gram-Negative Bacteria-Induced Post-Neurosurgical Meningitis

“…It has been reported that the invasiveness of A. baumannii and P. aeruginosa is higher than that of other NFGNB. 17 P. aeruginosa meningitis is much complicated to treat due to the existence of the quorum sensing system and biofilm formation, 18 which can induce drug resistance and lead to an increase in mortality. The carbapenem resistance rate of P. aeruginosa can be up to 30%, and the resistance rate of imipenem is even higher than that of meropenem.…”

High rates of extensively drug-resistant Acinetobacter baumannii in a Peruvian hospital 2013–2019

“…20 Of note was the high number of respiratory infections among outpatients which agrees with other studies in which this kind of A. baumannii infections are the most common on community patients. 20 Although community-acquired infections are less common than those acquired in a hospital, they have been described in different geographical areas [20][21][22][23] and are considered of special concern owing to related poor outcomes, especially with risk factors such as alcoholism or chronic obstructive pulmonary disease. 20,22 The lack of data concerning previous admissions might explain several outpatient infections as actually being hospital acquired; however, the differences in antibiotic resistance from in-and outpatients, as well as the differences in the evolution of MDR/XDR isolates in both populations, suggest a different origin and support the presumption of a truly communityacquired A. baumannii.…”