Clinical Outcomes and Bacterial Characteristics of Carbapenem-resistant <i>Acinetobacter Baumannii</i> Among Patients From Different Global Regions-Reference-Cited by-同舟云学术

Clinical Outcomes and Bacterial Characteristics of Carbapenem-resistant Acinetobacter Baumannii Among Patients From Different Global Regions

Published:2023-09-20 Issue: Volume: Page:
ISSN:1058-4838
Container-title:Clinical Infectious Diseases
language:en
Short-container-title:

Author:

Wang Minggui¹²^ORCID,Ge Lizhao³,Chen Liang⁴⁵,Komarow Lauren³,Hanson Blake⁶^ORCID,Reyes Jinnethe⁷,Cober Eric⁸,Alenazi Thamer⁹,Zong Zhiyong¹⁰,Xie Qing¹¹,Liu Zhengyin¹²,Li Lanjuan¹³,Yu Yunsong¹⁴^ORCID,Gao Hainv¹⁵,Kanj Souha S¹⁶,Figueroa Jairo¹⁷,Herc Erica¹⁸,Cordova Ezequiel¹⁹^ORCID,Weston Gregory²⁰,Ananth Tambyah Paul²¹,Garcia-Diaz Julia²²,Kaye Keith S²³²⁴^ORCID,Dhar Sorabh²⁵,Munita Jose M²⁶,Salata Robert A²⁷,Vilchez Samuel²⁸,Stryjewski Martin E²⁹,Villegas Botero Maria Virginia³⁰,Iovleva Alina³¹,Evans Scott R²³²^ORCID,Baum Keri³³,Hill Carol³³,Kreiswirth Barry N⁴,Patel Robin³⁴³⁵^ORCID,Paterson David L³⁶,Arias Cesar A³⁷³⁸,Bonomo Robert A²⁷³⁹⁴⁰⁴¹⁴²,Chambers Henry F⁴³,Fowler Vance G³³,Satlin Michael J⁴⁴,van Duin David⁴⁵^ORCID,Doi Yohei³¹⁴⁶,Kanj Souha S,Zhang Fujie,Lok Judith J,Salata Robert A,Stryjewski Martin,Castelnuovo Valentina Di,Gutierrez Jose Millan Oñate,Cober Eric,Richter Susan,Anderson Deverick J,Evans Beth,Hill Carol,Cross Heather R,Baum Keri,Arias Rebekka,Fowler Vance G,Ordoñez Karen,Jaco Jesse T,L Linghua,Kreiswirth Barry N,Manca Claudia,Chen Liang,Desai Samit,He Erica,Cordov Ezequiel,Riosec Maria,Vilche Samuel,Sanche Marisa L,Valderram Sandra,Figuero Jairo,Arias Cesar A,Dinh An Q,Panesso Diane,Rydell Kirsten,Tra Truc T,Hu Fupin,Su Jiachun,Jiang Jianping,Wang Minggui,Xu Xiaogang,Yan Yang,Munita Jose M,Spence Maria,Alenazi Thamer,Bonomo Robert A,Marshall Steven H,Rudin Susan D,Huskins Charles,Greenwood-Quaintance Kerry,Patel Robin,Schmidt-Malan Suzannah,Revolinski Sara,Wortmann Glenn,Kalayjian Robert C,Weston Gregory,Ostrowsky Belinda,Patel Gopi,Eiras Daniel,Kim Angela,Garcia-Diaz Julia,Salcedo Soraya,Farrell John J,Liu Zhengyin,Henderson Andrew,Paterso David L,Xie Qing,Kaye Keith S,Gao Hainv,Y Yunsong,Water Mary,Fries Bettina C,Eilertson Brandon,Marimuthu Kalisvar,Ng Oon Tek,De Partha Pratim,Chew Kean Lee,Smitasin Nares,Tambyah Paul Ananth,Gallagher Jason C,Peleg Anton,Leroi Marcel,Li Lanjuan,Xiao Yonghong,Komarow Lauren,Ge Lizhao,Evans Scott,McCarty Todd,Chambers Henry F,Garner Omai B,Abbo Lilian M,van Duin David,Lautenbach Ebbing,Han Jennifer H,Doi Yohei,Wong Darren,Hanson Blake,Reyes Jinnethe,Botero Maria Virginia Villegas,Dia Lorena,Perez Federico,Banerjee Ritu,Dhar Sorabh,Satlin Michael J,Westblade Lars F,Zong Zhiyong,

Affiliation:

1. Institute of Antibiotics, Huashan Hospital, Fudan University , Shanghai , China

2. Key Laboratory of Clinical Pharmacology of Antibiotics, National Health Commission of People's Republic of China , Shanghai , China

3. The Biostatistics Center, George Washington University , Rockville, Maryland , USA

4. Center for Discovery and Innovation, Hackensack Meridian Health , Nutley, New Jersey , USA

5. Department of Medical Sciences, Hackensack Meridian School of Medicine , Nutley, New Jersey , USA

6. Center for Infectious Diseases and Microbial Genomics, UTHealth, McGovern School of Medicine at Houston , Houston, Texas , USA

7. Molecular Genetics and Antimicrobial Resistance Unit, Universidad El Bosque , Bogotá , Colombia

8. Department of Infectious Diseases, Cleveland Clinic , Cleveland, Ohio , USA

9. College of Medicine, King Abdulaziz Medical City , Riyadh , Saudi Arabia

10. Center of Infectious Diseases, West China Hospital of Sichuan University , Chengdu , China

11. Department of Infectious Disease, Ruijin Hospital, Shanghai Jiaotong University , Shanghai , China

12. Infectious Disease Section, Department of Internal Medicine, Peking Union Medical College Hospital , Beijing , China

13. State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital of Medical School of Zhejiang University , Hangzhou , China

14. Department of Infectious Diseases, Sir Run Shaw Hospital, Zhejiang University School of Medicine , Hangzhou , China

15. Department of Infectious Diseases, Shulan Hangzhou Hospital , Hangzhou , China

16. Division of Infectious Diseases, American University of Beirut Medical Center , Beirut , Lebanon

17. Department of Infectious Diseases, Hospital Universitario Erasmo Meoz ESE , Cúcuta , Colombia

18. Division of Infectious Diseases, Department of Medicine, Henry Ford Hospital , Detroit, Michigan , USA

19. Infectious Diseases Unit, Hospital Cosme Argerich de Buenos Aires , Buenos Aires , Argentina

20. Division of Infectious Diseases, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine , Bronx, New York , USA

21. Infectious Diseases Translational Research Programme, National University of Singapore , Singapore , Singapore

22. Division of Infectious Diseases, Ochsner Medical Center , New Orleans, Louisiana , USA

23. Division of Infectious Diseases, Department of Internal Medicine, University of Michigan , Ann Arbor, Michigan , USA

24. Division of Allergy, Immunology and Infectious Diseases, Department of Medicine, Rutgers Robert Wood Johnson Medical School , New Brunswick, New Jersey , USA

25. Division of Infectious Disease, School of Medicine, Wayne State University , Detroit, Michigan , USA

26. Millennium Initiative for Collaborative Research on Bacterial Resistance (MICROB-R), Instituto de Ciencias e Innovación en Medicina, Facultad de Medicine, Clínica Alemana, Universidad del Desarrollo , Santiago , Chile

27. Department of Medicine, Case Western Reserve University School of Medicine , Cleveland, Ohio , USA

28. Center for Infectious Disease Research, Department of Microbiology and Parasitology, School of Medicine, National Autonomous University of Nicaragua , Leon , Nicaragua

29. Department of Medicine and Division of Infectious Diseases, Centro de Educación Médica e Investigaciones Clínicas , Buenos Aires , Argentina

30. Grupo de Resistencia Antimicrobiana y Epidemiología Hospitalaria (RAEH), Universidad El Bosque , Bogotá , Colombia

31. Division of Infectious Diseases, Department of Medicine, University of Pittsburgh School of Medicine , Pittsburgh, Pennsylvania , USA

32. Department of Biostatics and Bioinformatics, Milken Institute School of Public Health, George Washington University , Washington, District of Columbia , USA

33. Duke Clinical Research Institute, Duke University School of Medicine , Durham, North Carolina , USA

34. Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo Clinic , Rochester, Minnesota , USA

35. Division of Public Health, Infectious Diseases and Occupational Medicine, Department of Medicine, Mayo Clinic , Rochester, Minnesota , USA

36. Department of Infectious Diseases, University of Queensland Centre for Clinical Research, Royal Brisbane and Women's Hospital , Brisbane , Australia

37. Division of Infectious Diseases, Houston Methodist Hospital and Houston Methodist Research Institute , Houston, Texas , USA

38. Center for Infectious Diseases Research, Houston Methodist Hospital and Houston Methodist Research Institute , Houston, Texas , USA

39. Case Western Reserve University VA Center for Antimicrobial Resistance and Epidemiology (Case VA CARES), Research Service, Louis Stokes Cleveland Department of Veterans Affairs Medical Center , Cleveland, Ohio , USA

40. Department of Pharmacology, Case Western Reserve University School of Medicine , Cleveland, Ohio , USA

41. Department of Molecular Biology and Microbiology, Case Western Reserve University School of Medicine , Cleveland, Ohio , USA

42. Department of Biochemistry, Case Western Reserve University School of Medicine , Cleveland, Ohio , USA

43. Department of Medicine, University of California SanFrancisco , San Francisco, California , USA

44. Division of Infectious Diseases, Department of Medicine, Weill Cornell Medicine , New York, New York , USA

45. Division of Infectious Diseases, Department of Medicine, University of North Carolina School of Medicine , Chapel Hill, North Carolina , USA

46. Department of Microbiology and Infectious Diseases, Fujita Health University School of Medicine , Aichi , Japan

Abstract

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.

Funder

NIAID

National Natural Science Foundation of China

NIH

Department of Veterans Affairs

Publisher

Oxford University Press (OUP)

Subject

Infectious Diseases,Microbiology (medical)

Link

https://academic.oup.com/cid/advance-article-pdf/doi/10.1093/cid/ciad556/52071989/ciad556.pdf

Reference30 articles.