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. 2015 Feb;70(2):144-52.
doi: 10.1016/j.jinf.2014.09.004. Epub 2014 Sep 19.

Influence of ACB complex genospecies on clinical outcomes in a U.S. hospital with high rates of multidrug resistance

Margaret A Fitzpatrick  1 , Egon Ozer  2 , Maureen K Bolon  2 , Alan R Hauser  3
Affiliations

Influence of ACB complex genospecies on clinical outcomes in a U.S. hospital with high rates of multidrug resistance

Margaret A Fitzpatrick et al. J Infect. 2015 Feb.

Abstract

Objectives: Bacteria within the Acinetobacter calcoaceticus-Acinetobacter baumannii (ACB) complex commonly cause nosocomial infection and are often multidrug resistant. Advances in genospecies typing allow for speciation within the ACB complex; however, little is known about the effect of genospecies on patient outcomes.

Methods: Adult patients with ACB complex bacteremia from Jan 2005-Oct 2012 were included. Bacterial isolates were speciated by rpoB gene sequence analysis, and clinical data were collected.

Results: Of 147 patients with ACB complex bacteremia, 116 had A. baumannii (78.9%), 28 had Acinetobacter pittii (19.0%), and 3 had Acinetobacter nosocomialis (2.0%). A. baumannii bacteremia was associated with greater comorbidity and was more frequently multidrug resistant (79% vs. 16%, p < 0.01). Multidrug resistant A. baumannii but not susceptible A. baumannii was associated with worse outcomes compared to non-baumannii ACB complex bacteremia. Neither multidrug resistance nor genospecies was an independent predictor of mortality, but receipt of appropriate therapy was associated with decreased risk of mortality (OR, 0.13; 95% CI, 0.04-0.44; p < 0.01).

Conclusions: A. baumannii bacteremia is associated with worse clinical outcomes than non-baumannii ACB complex bacteremia. The difference, however, appears to be related to multidrug resistance and attendant receipt of appropriate therapy rather than genospecies.

Keywords: Acinetobacter baumannii; Acinetobacter calcoaceticus; Bacteremia; Genome; Multidrug resistance.

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Figures

Figure 1
Figure 1
Kaplan-Meier survival curves for 147 patients with susceptible A. baumannii, MDR A. baumannii and non-baumannii Acinetobacter calcoaceticus-Acinetobacter baumannii complex bacteremia for 30 days post-infection.
See this image and copyright information in PMC

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