Citations 1
Clinical Outcomes and Bacterial Characteristics of Carbapenem-resistant Acinetobacter baumannii Among Patients From Different Global Regions
Wang, Minggui , Ge, Lizhao , Chen, Liang , Komarow, Lauren , Hanson, Blake , Cober, Eric , Alenazi, Thamer H. , Xie, Qing , Liu, Zhengyin , Li, Lanjuan , Yu, Yunsong , Gao, Hainv , Figueroa, Jairo, Herc, Erica , Córdova, Ezequiel , Weston, Gregory , Kaye, Keith S. , Dhar, Sorabh , Munita, José M. , Salata, Robert A. , Vilchez, Samuel, Stryjewski, Martín E. , Iovleva, Alina , Evans, Scott , Baum, Keri, Hill, Carol , Kreiswirth, Barry N. , Patel, Robin , Arias, Cesar A, Chambers, Henry F. , Fowler, Vance G. , Satlin, Michael J. , Investigators, Multi-Drug Resistant Organism Network, Zhang, Fujie , Castelnuovo, Valentina Di, Gutierrez, Jose Millan Oñate, Evans, Beth , Cross, H. R. , Arias, Rebekka M. , Fowler, Vance G, Ordóñez, Karen , Li, Linghua , Kreiswirth, Barry N , Desai, Samit, Rioseco, María Luisa, Vilchez, Samuel, Sánchez, Marisa , Valderrama, Sandra , Figueroa, Jairo, Arias, Cesar A, Dinh, An Q , Panesso, Diane, Rydell, Kirsten, Tran, Truc T. , Jiang, Jianping , Xu, Xiaogang , Spencer, María, Marshall, Steven H. , Rudin, Susan D., Greenwood-Quaintance, Kerry, Schmidt-Malan, Suzannah M., Revolinski, Sara , Wortmann, Glenn , Kalayjian, Robert C. , Ostrowsky, Belinda , Patel, Gopi , Eiras, Daniel , Garcia-Diaz, Julia, Farrell, John J. , Paterson, David L, Kaye, Keith S, Waters, Mary Jo, Eilertson, Brandon , Ng, Oon Tek , De, Partha Pratim, Chew, Kean Lee , Smitasin, Nares , Gallagher, Jason C , Leroi, Marcel , McCarty, Todd P , Lautenbach, Ebbing , Hanson, Blake, Perez, Federico, Banerjee, Ritu , Dhar, Sorabh, Westblade, Lars F. , Yu, Yunsong , Cordova, Ezequiel , Kaye, Keith S , Evans, Scott R , Patel, Robin , van Duin, David , Pérez, Federico , Jiang, Jianping , Chen, Liang , Wang, Minggui , Munita, Jose M , Reyes, Jinnethe , Zong, Zhiyong , Kanj, Souha S. , Tambyah, Paul Anantharajah , Garcia‐Diaz, Julia , Villegas, María Virginia , Kreiswirth, Barry N , Paterson, David L. , Arias, Cesar A, Bonomo, Robert A. , Fowler, Vance G. , Doi, Yohei , Investigators, Multi-Drug Resistant Organism Network, Lok, Judith J. , Richter, Susan, Anderson, Deverick J. , Evans, Beth, Cross, Heather R, Fowler, Vance G, Jacob, Jesse T. , Manca, Claudia , Vilchez, Samuel, Figueroa, Jairo, Arias, Cesar A, Hu, Fupin , Su, Jiachun , Wang, Minggui, Xu, Xiaogang, Yang, Yang, Huskins, W. Charles , Greenwood‐Quaintance, Kerryl E. , Kim, Angela , Garcia-Diaz, Julia, Salcedo, Soraya , Henderson, Andrew , Paterson, David L, Kaye, Keith S, Fries, Bettina C. , Marimuthu, Kalisvar , Peleg, Anton Yariv , Xiao, Yonghong , Garner, Omai B. , Abbo, Lilian M. , Han, Jennifer , Wong, Darren , Hanson, Blake, Díaz, Lorena
Clinical Infectious Diseases | September 22, 2023 | Volume: 78 | Issue: 2 | Pages: 248-258
Abstract Background Carbapenem-resistant Acinetobacter baumannii (CRAb) is 1 of the most problematic antimicrobial-resistant bacteria. We sought to elucidate the international epidemiology and clinical impact of CRAb. Methods In a prospective observational cohort study, 842 hospitalized patients with a clinical CRAb culture were enrolled at 46 hospitals in five global regions between 2017 and 2019. The primary outcome was all-cause mortality at 30 days from the index culture. The strains underwent whole-genome analysis. Results Of 842 cases, 536 (64%) represented infection. By 30 days, 128 (24%) of the infected patients died, ranging from 1 (6%) of 18 in Australia-Singapore to 54 (25%) of 216 in the United States and 24 (49%) of 49 in South-Central America, whereas 42 (14%) of non-infected patients died. Bacteremia was associated with a higher risk of death compared with other types of infection (40 [42%] of 96 vs 88 [20%] of 440). In a multivariable logistic regression analysis, bloodstream infection and higher age-adjusted Charlson comorbidity index were independently associated with 30-day mortality. Clonal group 2 (CG2) strains predominated except in South-Central America, ranging from 216 (59%) of 369 in the United States to 282 (97%) of 291 in China. Acquired carbapenemase genes were carried by 769 (91%) of the 842 isolates. CG2 strains were significantly associated with higher levels of meropenem resistance, yet non-CG2 cases were over-represented among the deaths compared with CG2 cases. Conclusions CRAb infection types and clinical outcomes differed significantly across regions. Although CG2 strains remained predominant, non-CG2 strains were associated with higher mortality. Clinical Trials Registration. NCT03646227.