![]() carbapenem-resistant Acinetobacter baumannii (CRAB) and CRPA were found to cause greater than 80% of carbapenem-resistant infections. In a study of acute care hospitals in the U.S. In 2017, there were an estimated 8500 cases in hospitalized patients and 700 deaths. baumannii has been listed as a new urgent threat by the Centers for Disease Control and Prevention’s 2019 Antibiotic Resistance Threat Report. The 30-day mortality rate of CRPA infections, even with appropriate treatment is 30%. Carbapenem-resistant organisms (CROs), specifically carbapenem-resistant Pseudomonas aeruginosa (CRPA), have been identified as critical pathogens due to their enhanced transmissibility and limited treatment options. ![]() aeruginosa are often multi-drug resistant, including carbapenem resistant. A systematic review identified Acinetobacter baumannii and Pseudomonas aeruginosa infections had a raw mortality rate of 47% and 23%, respectively. ![]() have been identified as major causes of nosocomial infections due to their extensive antimicrobial resistance, ability to cause outbreaks, and association with negative outcomes such as increased lengths of stay (LOS) and higher mortality rates. Gram-negative organisms such as Acinetobacter and Pseudomonas spp. In 2015, there were approximately 687,000 hospital acquired infections (HAIs) in United States acute care hospitals and an estimated 72,000 patients died during their hospitalization. Recognizing these factors would encourage clinicians to treat these patients in a timely manner to improve outcomes of patients infected with these organisms. ![]() Positive blood cultures and more comorbidities were associated with higher odds for mortality in patients with CRAB and CRPA. In CRAB and CRPA, among patients from inpatient care settings, blood cultures were associated with a decreased LOS compared to urine cultures. In patients with CRAB and CRPA blood cultures, higher Charlson score was associated with increased odds of 90-day mortality. Positive blood cultures were associated with an increased odds of 90-day mortality compared to urine cultures in patients with CRAB (OR 6.98, 95% CI 3.55–13.73) and CRPA (OR 2.82, 95% CI 2.04–3.90). ResultsĬRAB and CRPA were identified in 1,048 and 8,204 unique patients respectively, with 90-day mortality rates of 30.3% and 24.5% and inpatient post-LOS of 26 and 27 days. Multivariable cluster adjusted regression models were fit to assess the association of post-culture LOS among inpatient and long-term care (LTC) and to identify factors associated with 90-day and 365-day mortality after positive CRAB and CRPA cultures. Carbapenem resistance was defined as non-susceptibility to imipenem, meropenem and/or doripenem. This was a national retrospective cohort study of Veterans with CRAB or CRPA positive cultures from 2013 to 2018, conducted at Hines Veterans Affairs Hospital. The objective of this study was to describe CRAB and CRPA epidemiology and identify factors associated with mortality and length of stay (LOS) post-culture. Carbapenem-resistant Acinetobacter baumannii (CRAB) and carbapenem-resistant Pseudomonas aeruginosa (CRPA) are a growing threat.
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