Prevalence of multidrug-resistant Acinetobacter baumannii in a critical care setting: A tertiary teaching hospital experience

Abstract

Background: The management of Acinetobacter baumannii infection is considered a challenge especially in an intensive care setting. The resistance rate makes it difficult to manage and is believed to lead to higher mortality. We aim to investigate the prevalence of Acinetobacter baumannii and explore how different antibiotic regimens could impact patient outcomes as there are no available published data to reflect our population in our region. Methods: We conducted a retrospective review of all infected adult patients admitted to the intensive care unit at King Fahad University Hospital with a confirmed laboratory diagnosis of Acinetobacter baumannii from 1 January 2013 until 31 December 2017. Positive cultures were obtained from the microbiology department and those meeting the inclusive criteria were selected. Variables were analyzed using descriptive analysis and cross-tabulation. Results were further reviewed and audited by blinded co-authors. Results: A comprehensive review of data identified 198 patients with Acinetobacter baumannii. The prevalence of Acinetobacter baumannii is 3.37%, and the overall mortality rate is 40.81%. Our sample consisted mainly of male patients, that is, 68.7%, with a mean age of 49 years, and the mean age of female patients was 56 years. The mean age of survivors was less than that of non-survivors, that is, 44.95 years of age. We observed that prior antibiotic use was higher in non-survivors compared to survivors. From the review of treatment provided for patients infected with Acinetobacter baumannii, 65 were treated with colistin alone, 18 were treated with carbapenems, and 22 were treated with a combination of both carbapenems and colistin. The mean length of stay of Acinetobacter baumannii–infected patients was 20.25 days. We found that the survival rates among patients who received carbapenems were higher compared to those who received colistin. Conclusion: We believe that multidrug-resistant Acinetobacter baumannii is prevalent and associated with a higher mortality rate and represents a challenging case for every intensive care unit physician. Further prospective studies are needed.

Prevalence of multidrug-resistant Acinetobacter baumannii in endotracheal aspirate samples: Experience at a tertiary hospital

“…22 In another study, the mean hospital stay of patients with A. baumannii is 20.25 days. 23 23 In our study, a total of 25 (48%) patients had PVAP. A total of 9 patients (36%) had early-onset PVAP and 16 (64%) had late-onset PVAP (P < 0.001).…”

Acinetobacter baumannii: assessing susceptibility patterns, management practices, and mortality predictors in a tertiary teaching hospital in Lebanon

“…Length of stay (LOS) prior to event : refers to the duration of hospitalization before the onset of infection [ 33 ].…”

Discernment of Acinetobacter Species in World Scenario

“…Our research revealed that the survival rates among patients receiving carbapenems had higher rates of death than those receiving colistin. 43 A study on Epidemiology and outcomes a s s o c i ate d w i t h ca r b a p e n e m -re s i sta nt Acinetobacter baumannii and carbapenemresistant Pseudomonas aeruginosa: a retrospective cohort study in 2022 by Amanda vivo et al The 90-day mortality rates for CRAB and CRPA were 30.3% and 24.5%, respectively, and the inpatient post-LOS was 26 and 27 days in 1,048 and 8,204 different patients, respectively. In comparison to urine cultures, positive blood cultures in patients with CRAB (OR 6.98, 95% CI 3.55-13.73) and CRPA (OR 2.82, 95% CI 2.04-3.90) were linked to higher odds of 90-day mortality.…”