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 Bou
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.
1These authors contributed equally to this article.
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