395. Epidemiology and Microbiology of Acinetobacter baumannii Infections at Summa Health System
Session: Poster Abstract Session: Gram Negative Infection - Epidemiology and Prevention
Friday, October 21, 2011
Room: Poster Hall B1
Handouts
  • IDSA Poster Acinetobacter 2011 Final Version - PDF Copy.pdf (428.7 kB)
  • Background: 

    Acinetobacter baumannii colonization and infection has been of rising concern across the nation and at Summa Health System.  The concerns for multi-drug resistance (MDR) emerged when three patients in 2009 were found to have pan resistant isolates.  Published data has shown increases in MDR and identified the following at risk factors for such; ventilator associated pneumonia, intravascular devices, previous hospitalization within one year and previous antibiotic use.  The objective of this study is to evaluate the epidemiology of A. baumannii at Summa Health System.  Secondary objectives include identifying risk factors for MDR, outcomes in patients with positive A. baumannii cultures, microbiology susceptibility patterns and clonal relationships by pulsed-field gel electrophoresis.

    Methods:

    Patients admitted with positive cultures for A. baumannii were identified through the microbiology lab from January 2009 to December 2010. Clinical information was retrospectively collected by reviewing the electronic databases.  Colonization versus infection was determined by a pre-identified set of criteria. MDR was characterized as a pathogen being resistant to ≥3 antibiotic classes. 

    Results: 

    A total of 146 patients, 110 MDR (75.3%) and 36 susceptible (24.7%) were evaluated.  Mean age was higher (59 vs 50, t=2.972, df=144, p=0.003) and cardiovascular (76.4% vs 50%, p=0.003) and respiratory (46.3% vs 25%, p=0.024) comorbidities were more prevalent in the MDR patients.  Patients admitted from extended care facility (ECF) were more likely to have a MDR pathogen (OR 45.2, 95% CI, 6.0, 341.9) as were patients who had been on any antibiotic in the previous 30 days of admission (p=0.002). There were no significant differences in overall length of stay (LOS) or mortality at 30 (15.5% vs 13.9%, p=0.820) and 90 days (33.6% vs 25%, p=0.333).

    Conclusion: 

    Possessing cardiovascular and respiratory comorbidities is a risk factor for acquiring an MDR pathogen. Patients admitted from an ECF are 45 times more likely to have MDR A. baumannii, which may be related to the higher use of previous antibiotics in the MDR group as well. Overall length of stay and mortality was not affected by MDR status. 


    Subject Category: N. Hospital-acquired and surgical infections, infection control, and health outcomes including general public health and health services research

    Hallie Barr, PharmD1, Timothy R. Pasquale, PharmD1, Joseph DiPersio, PhD1, M. David Gothard, M.S.2 and Hector Bonilla, MD1, (1)Summa Health System, Akron, OH, (2)Research, Children's Hospital Medical Center of Akron, Akron, OH

    Disclosures:

    H. Barr, None

    T. R. Pasquale, None

    J. DiPersio, None

    M. D. Gothard, None

    H. Bonilla, None

    Findings in the abstracts are embargoed until 12:01 a.m. EST Thursday, Oct. 20 with the exception of research findings presented at IDSA press conferences.