Nosocomial bloodstream infections caused by Acinetobacter species in United States hospitals: clinical features, molecular epidemiology, and antimicrobial susceptibility

Hilmar Wisplinghoff; Michael B Edmund; Michael A Pfaller; Ronald N Jones; Richard P Wenzel; Harald Seifert

doi:10.1086/314040

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Nosocomial bloodstream infections caused by Acinetobacter species in United States hospitals: clinical features, molecular epidemiology, and antimicrobial susceptibility

Journal article

Open access

Peer reviewed

Nosocomial bloodstream infections caused by Acinetobacter species in United States hospitals: clinical features, molecular epidemiology, and antimicrobial susceptibility

Hilmar Wisplinghoff, Michael B Edmund, Michael A Pfaller, Ronald N Jones, Richard P Wenzel and Harald Seifert

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, Vol.31(3), pp.690-697

09/2000

DOI: 10.1086/314040

PMID: 11017817

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Abstract

We examined the clinical and epidemiological features of nosocomial bloodstream infections (BSIs) caused by Acinetobacter species and observed from 1 March 1995 through 28 February 1998 at 49 United States hospitals (SCOPE National Surveillance Program). Acinetobacter species were found in 24 hospitals (49%) and accounted for 1.5% of all nosocomial BSIs reported. One hundred twenty-nine isolates were identified either as A. baumannii (n=111) or other Acinetobacter species (n=18). Patients with A. baumannii BSI, compared with patients with nosocomial BSI caused by other gram-negative pathogens, were more frequently observed in the intensive care unit (69% vs. 47%, respectively; P<.001; odds ratio [OR] 2.4; 95% confidence interval [CI] 1.6-3.7) and were more frequently receiving mechanical ventilation (58% vs. 30%, respectively; P<.001; OR 3.2; 95% CI 2.1-4.8). Crude mortality in patients with A. baumannii BSI was 32%. Molecular relatedness of strains was studied by use of polymerase chain reaction-based fingerprinting. Clonal spread of a single strain occurred in 5 hospitals. Interhospital spread of epidemic A. baumannii strains was not observed. The most active antimicrobial agents against A. baumannii (90% minimum inhibitory concentration values) were imipenem (1 mg/L; 100% of isolates susceptible), amikacin (8 mg/L; 96%), tobramycin (4 mg/L; 92%), and doxycycline (4 mg/L; 91%). Thirty percent of isolates were resistant to > or =4 classes of antimicrobials and were considered to be multidrug resistant.

Polymerase Chain Reaction

Molecular Epidemiology

United States - epidemiology

Species Specificity

Humans

Middle Aged

Child, Preschool

Infant

Male

Acinetobacter - drug effects

Bacteremia - microbiology

Dose-Response Relationship, Drug

Microbial Sensitivity Tests

Aged, 80 and over

Bacteremia - blood

Adult

Female

Child

Infant, Newborn

Cross Infection - epidemiology

Acinetobacter - genetics

DNA, Bacterial - genetics

Hospitals

Cross Infection - microbiology

Adolescent

Acinetobacter - isolation & purification

Bacteremia - epidemiology

Aged

Anti-Bacterial Agents - pharmacology

Cross Infection - blood

Details

Title: Subtitle: Nosocomial bloodstream infections caused by Acinetobacter species in United States hospitals: clinical features, molecular epidemiology, and antimicrobial susceptibility
Creators: Hilmar Wisplinghoff - Institute of Medical Microbiology, Immunology and Hygiene, University of Cologne, Germany
Michael B Edmund
Michael A Pfaller
Ronald N Jones
Richard P Wenzel
Harald Seifert
Resource Type: Journal article
Publication Details: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, Vol.31(3), pp.690-697
DOI: 10.1086/314040
PMID: 11017817
NLM abbreviation: Clin Infect Dis
ISSN: 1058-4838
eISSN: 1537-6591
Publisher: United States
Language: English
Date published: 09/2000
Academic Unit: Infectious Diseases; Epidemiology; Pathology; Internal Medicine
Record Identifier: 9983905646202771

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