Cargando…

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...

Descripción completa

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:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10677258/
http://dx.doi.org/10.1093/ofid/ofad500.2464
_version_ 1785150087428571136
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
work_keys_str_mv AT harrisanthony 970assessingtheburdenofacinetobacterbaumanniiandcandidaaurisamongventilatedpatientsinmarylandastatewideperiodprevalencesurveyoftwourgentthreats
AT pineleslisa 970assessingtheburdenofacinetobacterbaumanniiandcandidaaurisamongventilatedpatientsinmarylandastatewideperiodprevalencesurveyoftwourgentthreats
AT kristiejohnsonj 970assessingtheburdenofacinetobacterbaumanniiandcandidaaurisamongventilatedpatientsinmarylandastatewideperiodprevalencesurveyoftwourgentthreats
AT oharalyndsaym 970assessingtheburdenofacinetobacterbaumanniiandcandidaaurisamongventilatedpatientsinmarylandastatewideperiodprevalencesurveyoftwourgentthreats
AT smithlaurenleigh 970assessingtheburdenofacinetobacterbaumanniiandcandidaaurisamongventilatedpatientsinmarylandastatewideperiodprevalencesurveyoftwourgentthreats
AT frenchindira 970assessingtheburdenofacinetobacterbaumanniiandcandidaaurisamongventilatedpatientsinmarylandastatewideperiodprevalencesurveyoftwourgentthreats
AT rubinjamie 970assessingtheburdenofacinetobacterbaumanniiandcandidaaurisamongventilatedpatientsinmarylandastatewideperiodprevalencesurveyoftwourgentthreats
AT perlmutterrebecca 970assessingtheburdenofacinetobacterbaumanniiandcandidaaurisamongventilatedpatientsinmarylandastatewideperiodprevalencesurveyoftwourgentthreats
AT hellerashley 970assessingtheburdenofacinetobacterbaumanniiandcandidaaurisamongventilatedpatientsinmarylandastatewideperiodprevalencesurveyoftwourgentthreats
AT kleinliore 970assessingtheburdenofacinetobacterbaumanniiandcandidaaurisamongventilatedpatientsinmarylandastatewideperiodprevalencesurveyoftwourgentthreats
AT blythedavid 970assessingtheburdenofacinetobacterbaumanniiandcandidaaurisamongventilatedpatientsinmarylandastatewideperiodprevalencesurveyoftwourgentthreats
AT vaethelisabeth 970assessingtheburdenofacinetobacterbaumanniiandcandidaaurisamongventilatedpatientsinmarylandastatewideperiodprevalencesurveyoftwourgentthreats