Bacteremic nosocomial pneumonia caused by Acinetobacter baumannii and Acinetobacter nosocomialis: a single or two distinct clinical entities?. (12th September 2012)

• Record Type: Journal Article
• Authors: Lee, Y.‐T.; Kuo, S.‐C.; Yang, S.‐P.; Lin, Y.‐T.; Chiang, D.‐H.; Tseng, F.‐C.; Chen, T.‐L.; Fung, C.‐P.
• Is Part Of: Clinical microbiology and infection. Volume 19:Number 7(2013:Jul.)
• Page Start: 640
• Page End: 645
• Publication Date: 2012-09-12
• Subjects: Medical microbiology -- Periodicals; Diagnostic microbiology -- Periodicals; Communicable diseases -- Periodicals; Infection -- Periodicals; 616.01
• DOI: 10.1111/j.1469-0691.2012.03988.x
• Languages: English
• ISSNs: 1198-743X

Abstract

<abstract abstract-type="main" xml:lang="en"> <title>Abstract</title> <p>The phenotypically indistinguishable <italic>Acinetobacter baumannii</italic> and <italic>Acinetobacter nosocomialis</italic> have become leading pathogens causing nosocomial pneumonia in critically ill patients. <italic>A. baumannii</italic> and <italic>A. nosocomialis</italic> nosocomial pneumonias were grouped as a single clinical entity previously. This study aimed to determine whether they are the same or a different clinical entity. A total of 121 patients with <italic>A. baumannii</italic> and 131 with <italic>A. nosocomialis</italic> bacteremic nosocomial pneumonia were included during an 8‐year period. Despite the similar Charlson co‐morbidity scores at admission, patients with <italic>A. baumannii</italic> pneumonia were more likely to have abnormal haematological findings, lobar pneumonia, significantly higher Acute Physiology and Chronic Health Evaluation II scores and higher frequency of shock at the onset of bacteraemia than those with <italic>A. nosocomialis</italic> pneumoni. <italic>A. baumannii</italic> isolates were resistant to more classes of antimicrobials, except colistin, and therefore the patients with <italic>A. baumannii</italic> pneumonia were more likely to receive inappropriate antimicrobial therapy. The 14‐day mortality was significantly higher in patients with <italic>A. baumannii</italic> pneumonia (34.7% vs. 15.3%, p 0.001). <italic>A. baumannii</italic> was an independent risk factor for mortality (OR, 2.03; 95% CI, 1.05–3.90; p 0.035) in the overall cohort after adjustment for other risk factors for death, including inappropriate antimicrobial therapy. The results demonstrated the difference in clinical presentation, microbial characteristics and outcomes between <italic>A. baumannii</italic> and <italic>A. nosocomialis</italic> nosocomial pneumonia, and supported that they are two distinct clinical entities.</p> </abstract>