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Volume 17, Number 6—June 2011

Dispatch

Multidrug-Resistant Acinetobacter baumannii Harboring OXA-24 Carbapenemase, Spain

Joshi Acosta, María Merino, Esther Viedma, Margarita Poza, Francisca Sanz, Joaquín R. Otero, Fernando Chaves, and Germán BouComments to Author 
Author affiliations: Author affiliations: Hospital Universitario 12 de Octubre, Madrid, Spain (J. Acosta, E. Viedma, F. Sanz, J.R. Otero, F. Chaves); Complejo Hospitalario Universitario La Coruña, La Coruña, Spain (M. Merino, M. Poza, G. Bou)

Main Article

Table 1

Clinical characteristic of patients with Acinetobacter baumannii bacteremia, Spain*

Characteristic Clone ABCA, n = 65 Clone ABNCA, n = 29 p value OR (95% CI)
Age, y 57.5 ± 14.2 58.7 ± 19.6 0.730 NA
Male sex
50 (76.9)
21 (72.4)
0.639
1.27 (0.47–3.45)
Concurrent conditions
Immunosuppression 12 (18.5) 6 (20.7) 0.800 0.87 (0.29–2.60)
Solid tumor 16 (24.6) 6 (20.7) 0.678 1.25 (0.43–3.62)
Hematologic malignancy 1 (1.5) 1 (3.4) 0.553 0.44 (0.03–7.25)
Diabetes mellitus 9 (13.8) 9 (31.0) 0.050 0.36 (0.12–1.03)
Liver cirrhosis 11 (16.9) 3 (10.3) 0.408 1.76 (0.45–6.88)
Heart failure 4 (6.2) 3 (10.3) 0.475 0.57 (0.12–2.72)
Chronic obstructive pulmonary disease 7 (10.8) 3 (10.3) 0.951 1.05 (0.25–4.37)
Liver transplant
15 (23.1)
7 (24.1)
0.911
0.94 (0.34–2.64)
Duration of hospitalization before A. baumannii bacteremia, d
34.8 ± 36.1
23.9 ± 27.5
0.150
NA
Hospital location
Intensive care unit 41 (63.1) 9 (31.0) 0.004 3.80 (1.50–9.66)
Medical ward 6 (9.2) 12 (41.4) 0.001 0.14 (0.05–0.44)
Surgical ward
18 (27.7)
8 (27.6)
0.992
1.00 (0.38–2.68)
Source of bacteremia
Catheter-related infection 25 (38.5) 9 (31.0) 0.489 1.39 (0.54–3.52)
Pneumonia associated with mechanical ventilation 18 (27.7) 1 (3.4) 0.006 10.72 (1.36–84.8)
None (primary bacteremia) 12 (18.5) 14 (48.3) 0.003 0.24 (0.09–0.63)
Intraabdominal infection 7 (10.8) 2 (6.9) 0.716 1.62 (0.32–8.37)
Urinary tract infection 3 (4.6) 2 (6.9) 0.642 0.65 (0.10–4.13)
Other
0
1 (3.4)
0.309
3.32 (2.43–4.52)
Carbapenem resistance
65 (100.0)
7 (24.1)
0.001
0.09 (0.50–0.20)
Prior colonization with A. baumannii
43/62 (69.4)
1/17 (5.9)
0.001
36.21(4.47–293.1)
Antimicrobial drugs used
Cephalosporin 7/62 (11.3) 3/29 (10.3) 0.893 1.10 (0.26–4.61)
Piperacillin/tazobactam 21/62 (33.9) 4/29 (13.8) 0.046 3.20 (0.98–10.41)
Fluorquinolone 24/62 (38.7) 9/29 (31.0) 0.478 1.40 (0.54–3.59)
Glycopeptide 44/62 (71.0) 12/29 (41.4) 0.007 3.46 (1.38–8.69)
Aminoglycoside 17/62 (27.4) 8/29 (27.6) 0.987 0.99 (0.37–2.66)
Carbapenem 41/62 (66.1) 11/29 (37.9) 0.011 3.20 (1.28–7.99)
>3 drugs
36/62 (58.1)
8/29 (27.6)
0.007
3.63 (1.40–9.47)
Invasive procedure or device
Central venous catheter† 51/64 (79.7) 15/29 (51.7) 0.006 3.66 (1.42–9.46)
Surgical procedure‡ 33/64 (51.6) 11/29 (37.9) 0.223 1.74 (0.71–4.27)
Mechanical ventilation†
49/64 (76.6)
14/29 (48.3)
0.007
3.50 (1.38–8.87)
Duration of hospitalization after A. baumannii bacteremia, d 46.6 ± 72.9 20.5 ± 21.2 0.050 NA
Died during hospitalization 35 (53.8) 9 (31.0) 0.041 2.59 (1.03–6.54)

*Values are mean ± SD or no. (%) except as indicated. Clone ABCA, A. baumannii clone A (AbH12O-A2); ABNCA, A. baumannii nonclone A; OR, odds ratio; CI, confidence interval; NA, not applicable.
†Week before bacteremia.
‡Month before bacteremia.

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1These authors contributed equally to this article.

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