1426. Patient demographics of infection with carbapenem-resistant Acinetobacter baumannii in a tertiary-care teaching hospital
Session: Poster Abstract Session: Epidemiology of Multiple Drug-Resistant Gram Negative Rods
Saturday, October 20, 2012
Room: SDCC Poster Hall F-H
Posters
  • Vaze et al-IDSA-2012( IDWEEK-2012) Ab Poster 17Sep2012.pdf (1.4 MB)
  • Background: Acinetobacter baumannii (Ab) causes hospital- and community-acquired infections; furthermore, multidrug resistant (MDR) phenotypes are increasing globally. The carbapenems are often the last resort for treating MDRAb infections. We report analysis of patient demographics and characteristics of infection with carbapenem-resistant Ab.

    Methods: From June 2010 to Dec 2011, 100 Abpositive-cultures in 64 patients were identified. Clinical and microbiological data were analyzed for risk factors and demographic features to derive relative risk, odds ratio, and 95% confidence interval. The analytical profile index was used to identify isolates, and an antibiogram for the first and repeat (second) isolates.

    Results: Of 100 samples, 49% were sputum samples from ventilated patients; 57% had an associated co-infection. Significant risk factors were working age (18-60 years), male gender, hospital stay more than 1 week but less than 1 month, prior hospitalization, progressive care nursing units, respiratory / mechanical ventilation, polymicrobial infections involving Ab, and prior antibiotic therapy.  Methicillin-resistant Staphylococcus aureus, Pseudomonas aeruginosa, and Klebsiella pneumoniaewere the significant co-infecting agents. The antibiogram demonstrated multidrug resistance in a majority of the isolates. Relative risk associated with ventilation, diabetes, and surgery was higher in repeat isolates than in first isolates and were MDR.

    Conclusion: Resistance to all carbapenems and colistin is increasing rapidly in repeat isolates; and leaves no or narrow therapeutic options to treat MDRAb infections.

    Nachiket Vaze, Christopher Emery, MD, Richard Hamilton, MD, Ari Brooks, MD and Suresh Joshi, MD, PhD, Drexel University College of Medicine, Philadelphia, PA

    Disclosures:

    N. Vaze, None

    C. Emery, None

    R. Hamilton, None

    A. Brooks, None

    S. Joshi, Merck & Co (R&D): Grant Investigator and Investigator, Research grant

    Findings in the abstracts are embargoed until 12:01 a.m. PST, Oct. 17th with the exception of research findings presented at the IDWeek press conferences.