Clinical and Epidemiological Significance of Carbapenem Resistance in Acinetobacter baumannii Infections |
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| Authors: | Ruthy Tal-Jasper David E. Katz Nadav Amrami Dor Ravid Dori Avivi Ronit Zaidenstein Tsilia Lazarovitch Mor Dadon Keith S. Kaye Dror Marchaim |
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| Affiliation: | aSackler School of Medicine, Tel Aviv University, Tel Aviv, Israel;bDepartment of Internal Medicine D, Shaare Zedek Medical Center, Jerusalem, Israel;cUnit of Infectious Diseases, Assaf Harofeh Medical Center, Zerifin, Israel;dClinical Microbiology Laboratory, Assaf Harofeh Medical Center, Zerifin, Israel;eDivision of Infectious Diseases, Detroit Medical Center, Wayne State University, Detroit, Michigan, USA |
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| Abstract: | ![]()
Carbapenems are considered the treatment of choice for Acinetobacter baumannii infections. Many facilities implement preventive measures toward only carbapenem-resistant A. baumannii (CRAB). However, the independent role of the carbapenem resistance determinant on patient outcomes remains controversial. In a 6-year analysis of adults with A. baumannii bloodstream infection (BSI), the outcomes of 149 CRAB isolates were compared to those of 91 patients with carbapenem-susceptible A. baumannii. In bivariable analyses, CRAB BSIs were significantly associated with worse outcomes and with a delay in the initiation of appropriate antimicrobial therapy (DAAT). However, in multivariable analyses, carbapenem resistance status was no longer associated with poor outcomes, while DAAT remained an independent predictor. The epidemiological significance of A. baumannii should not be determined by its resistance to carbapenems. |
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