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The Microbiological Characteristics of Acinetobacter Baumannii Associated With Early Mortality in Patients With Bloodstream Infection.
Lee, Chan Mi; Choi, Yunsang; Choi, Seong Jin; Moon, Song Mi; Kim, Eu Suk; Kim, Hong Bin; Ham, Sin Young; Park, Jeong Su; Yeom, Jinki; Song, Kyoung-Ho.
Affiliation
  • Lee CM; Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.
  • Choi Y; Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea.
  • Choi SJ; Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea.
  • Moon SM; Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea.
  • Kim ES; Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea.
  • Kim HB; Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea.
  • Ham SY; Department of Internal Medicine, Veterans Health Service Medical Center, Seoul, Republic of Korea.
  • Park JS; Department of Laboratory Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea.
  • Yeom J; Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, Republic of Korea.
  • Song KH; Department of Microbiology and Immunology, Seoul National University College of Medicine, Seoul, Republic of Korea.
Open Forum Infect Dis ; 11(7): ofae348, 2024 Jul.
Article in En | MEDLINE | ID: mdl-39006316
ABSTRACT

Background:

Despite rapid deaths resulting from Acinetobacter baumannii bacteremia, the clinical impact of the microbiological characteristics of A baumannii strains on early mortality (EM) is unclear. We aimed to identify the microbiological characteristics of A baumannii strains associated with EM.

Methods:

Clinical information and isolates from patients with A baumannii bacteremia from January 2015 to December 2021 were collected. EM was defined as death within 3 days of the initial positive blood culture, whereas late mortality meant death within 5-30 days. The microbiological characteristics of A baumannii were analyzed using multilocus sequence typing, polymerase chain reactions, and a Galleria mellonella in vivo infection model.

Results:

Among 130 patients, 69 (53.1%) died within 30 days and EM occurred in 38 (55.1% of 30-day deaths). Sequence type 191 (ST191) strain was more prevalent in patients with EM than in 30-day survivors (31.6% vs 6.6%). Regarding virulence genes, bfmS was more frequent (92.1% vs 47.5%), whereas bauA was less frequent (13.2% vs 52.5%) in patients with EM than in 30-day survivors. Higher clinical severity, pneumonia, and ST191 infection were identified as independent risk factors for EM. In the G mellonella infection model, ST191, bfmS+, and bauA- isolates showed higher virulence than non-ST191, bfmS-, and bauA+ isolates, respectively.

Conclusions:

ST191 and bfmS were more frequently found in the EM group. ST191 infection was also an independent risk factor for EM and highly virulent in the in vivo model. Tailored infection control measures based on these characteristics are necessary for A baumannii bacteremia management.
Key words

Full text: 1 Collection: 01-internacional Database: MEDLINE Language: En Journal: Open Forum Infect Dis Year: 2024 Document type: Article Country of publication:

Full text: 1 Collection: 01-internacional Database: MEDLINE Language: En Journal: Open Forum Infect Dis Year: 2024 Document type: Article Country of publication: