970. Assessing the burden of Acinetobacter baumannii and Candida auris among ventilated patients in Maryland: A statewide period prevalence survey of two urgent threats

BACKGROUND: To date, only one statewide prevalence survey has been performed for Acinetobacter baumannii (2009) in the United States, and no statewide prevalence survey has been performed for Candida auris. We aimed to determine the prevalence of A. baumannii and C. auris among mechanically ventilat...

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Detalles Bibliográficos
Autores principales: Harris, Anthony, Pineles, Lisa, Kristie Johnson, J, O’Hara, Lyndsay M, Smith, Lauren Leigh, French, Indira, Rubin, Jamie, Perlmutter, Rebecca, Heller, Ashley, Klein, Liore, Blythe, David, Vaeth, Elisabeth
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2023
Materias:
Abstract
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10677258/
http://dx.doi.org/10.1093/ofid/ofad500.2464
Descripción
Sumario:BACKGROUND: To date, only one statewide prevalence survey has been performed for Acinetobacter baumannii (2009) in the United States, and no statewide prevalence survey has been performed for Candida auris. We aimed to determine the prevalence of A. baumannii and C. auris among mechanically ventilated patients in Maryland. METHODS: The Maryland MDRO Prevention Collaborative performed a statewide point prevalence survey of mechanically ventilated patients admitted to acute care hospitals (ACH) and long-term care (LTC) facilities between March 7, 2023, and June 8, 2023. Surveillance cultures were obtained from all mechanically ventilated patients. Sputum, peri-anal, and arm/leg cultures were cultured for A. baumannii and antibiotic susceptibility testing was performed. Axilla/groin cultures were tested by PCR for C. auris. RESULTS: One hundred percent of all eligible healthcare facilities participated. 482 ventilated patients were included in the analysis. A. baumannii was cultured from at least one body site in 148/482 (31%) patients, CRAB was identified in 88/482 (18%) patients and C. auris in 31/470 (7%) patients. LTC patients were more likely to be colonized with A. baumannii (RR 7.7, 95% CI 5.1-11.5, p< .0001), with CRAB (RR 5.5, 95% CI 3.4-8.9, p< .0001) and C. auris (RR 2.0, CI 0.99-3.9, p=.05) compared to acute care hospital patients (Figure 1). Nine (29%) C. auris-positive patients were previously unknown to the Maryland Department of Health. Susceptibilities for A. baumannii are in Table 1. [Figure: see text] [Figure: see text] [Figure: see text] CONCLUSION: A. baumannii, CRAB and C. auris colonization are common among mechanically ventilated patients in both ACH and LTC facilities. Both pathogens were significantly more common in long-term care facilities than acute care facilities. Ventilated long-term care patients are an extremely high-risk population for emerging pathogens and surveillance and infection prevention efforts should be targeted to these facilities. DISCLOSURES: Anthony Harris, MD, MPH, Merck: Grant/Research Support|UpToDate: Infection Control Editor

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