Clinical and Epidemiological Significance of Carbapenem Resistance in Acinetobacter baumannii Infections

Carbapenems are considered the treatment of choice for Acinetobacter baumannii infections. Many facilities implement preventive measures toward only carbapenem-resistant A. baumannii (CRAB). However, the independent role of the carbapenem resistance determinant on patient outcomes remains controvers...

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Bibliographic Details
Published in:Antimicrobial agents and chemotherapy 2016-05, Vol.60 (5), p.3127-3131
Main Authors: Tal-Jasper, Ruthy, Katz, David E, Amrami, Nadav, Ravid, Dor, Avivi, Dori, Zaidenstein, Ronit, Lazarovitch, Tsilia, Dadon, Mor, Kaye, Keith S, Marchaim, Dror
Format: Article
Language:English
Subjects:
Acinetobacter baumannii
Acinetobacter baumannii - drug effects
Acinetobacter baumannii - pathogenicity
Acinetobacter Infections
Acinetobacter Infections - drug therapy
Acinetobacter Infections - epidemiology
Anti-Bacterial Agents
Anti-Bacterial Agents - therapeutic use
Carbapenems
Carbapenems - therapeutic use
Decapoda
Drug Resistance, Bacterial - genetics
Epidemiology and Surveillance
Humans
Kaplan-Meier Estimate
Microbial Sensitivity Tests
Multivariate Analysis
Retrospective Studies
RNA, Ribosomal, 16S - genetics
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Summary:Carbapenems are considered the treatment of choice for Acinetobacter baumannii infections. Many facilities implement preventive measures toward only carbapenem-resistant A. baumannii (CRAB). However, the independent role of the carbapenem resistance determinant on patient outcomes remains controversial. In a 6-year analysis of adults with A. baumannii bloodstream infection (BSI), the outcomes of 149 CRAB isolates were compared to those of 91 patients with carbapenem-susceptible A. baumannii In bivariable analyses, CRAB BSIs were significantly associated with worse outcomes and with a delay in the initiation of appropriate antimicrobial therapy (DAAT). However, in multivariable analyses, carbapenem resistance status was no longer associated with poor outcomes, while DAAT remained an independent predictor. The epidemiological significance of A. baumannii should not be determined by its resistance to carbapenems.
ISSN:0066-4804
1098-6596
DOI:10.1128/aac.02656-15