Clinical Outcomes of Hospital-Acquired Infection with Acinetobacter nosocomialis and Acinetobacter pittii.

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Clinical Outcomes of Hospital-Acquired Infection with Acinetobacter nosocomialis and Acinetobacter pittii.

Antimicrob Agents Chemother. 2014 May 12;

Authors: Chusri S, Chongsuvivatwong V, Rivera JI, Silpapojakul K, Singkhamanan K, McNeil E, Doi Y

Abstract
The role of Acinetobacter nosocomialis and Acinetobacter pittii, which belong to Acinetobacter calcoaceticus-Acinetobacter baumannii (Acb) complex, in hospital-acquired infections is increasingly recognized. Here we describe a retrospective cohort study of hospital-acquired Acb complex infections at a university hospital in Thailand. A total of 222 unique cases were identified between January, 2010 and December, 2011. The genomospecies of the Acb complex isolates were classified as follows: A. baumannii, 197 (89%), A. nosocomialis, 18 (8%), and A. pittii, 7 (3%). All A. nosocomialis and A. pittii isolates were susceptible to imipenem and meropenem. The patients infected with A. nosocomialis and A. pittii had lower 30-day mortality than those infected with carbapenem-susceptible A. baumannii (P = 0.025) and carbapenem-resistant A. baumannii (P = 0.013). The factors influencing 30-day mortality were infection with non-baumannii Acb complex (hazard ratio [HR], 0.12; 95% confidence interval [CI], 0.03-0.51; P = 0.004), infection with carbapenem-resistant A. baumannii (HR, 1.57; 95% CI, 0.89-2.79; P = 0.105), appropriate empirical antimicrobial therapy (HR, 0.38; 95% CI, 0.23-0.61; P < 0.001) and higher APACHE II score (HR, 1.15; 95% CI, 1.10-1.19; P < 0.001). In Galleria mellonella assays the survival rates were significantly higher for the larvae infected with A. nosocomialis or A. pittii compared with those infected with either carbapenem-susceptible A. baumannii or carbapenem-resistant A. baumannii, but no differences in survival rates were observed between carbapenem-susceptible A. baumannii and carbapenem-resistant A. baumannii. These findings suggest intrinsic differences in virulence between non-baumannii Acb complex species and A. baumannii, but not between carbapenem-susceptible and resistant A. baumannii.

PMID: 24820079 [PubMed - as supplied by publisher]

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