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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...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10677258/ http://dx.doi.org/10.1093/ofid/ofad500.2464 |
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author | 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 |
author_facet | 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 |
author_sort | Harris, Anthony |
collection | PubMed |
description | 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 |
format | Online Article Text |
id | pubmed-10677258 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-106772582023-11-27 970. Assessing the burden of Acinetobacter baumannii and Candida auris among ventilated patients in Maryland: A statewide period prevalence survey of two urgent threats 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 Open Forum Infect Dis Abstract 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 Oxford University Press 2023-11-27 /pmc/articles/PMC10677258/ http://dx.doi.org/10.1093/ofid/ofad500.2464 Text en © The Author(s) 2023. Published by Oxford University Press on behalf of Infectious Diseases Society of America. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Abstract 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 970. Assessing the burden of Acinetobacter baumannii and Candida auris among ventilated patients in Maryland: A statewide period prevalence survey of two urgent threats |
title | 970. Assessing the burden of Acinetobacter baumannii and Candida auris among ventilated patients in Maryland: A statewide period prevalence survey of two urgent threats |
title_full | 970. Assessing the burden of Acinetobacter baumannii and Candida auris among ventilated patients in Maryland: A statewide period prevalence survey of two urgent threats |
title_fullStr | 970. Assessing the burden of Acinetobacter baumannii and Candida auris among ventilated patients in Maryland: A statewide period prevalence survey of two urgent threats |
title_full_unstemmed | 970. Assessing the burden of Acinetobacter baumannii and Candida auris among ventilated patients in Maryland: A statewide period prevalence survey of two urgent threats |
title_short | 970. Assessing the burden of Acinetobacter baumannii and Candida auris among ventilated patients in Maryland: A statewide period prevalence survey of two urgent threats |
title_sort | 970. assessing the burden of acinetobacter baumannii and candida auris among ventilated patients in maryland: a statewide period prevalence survey of two urgent threats |
topic | Abstract |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10677258/ http://dx.doi.org/10.1093/ofid/ofad500.2464 |
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