Clinical characteristics of 1,260 patients during an outbreak of carbapenem-resistant Acinetobacter spp in Porto Alegre, Brazil

Abstract

Introdution: Over the last decade, Acinetobacter baumannii has been an important cause of nosocomial infections worldwide. The objective of this study was to assess clinical and epidemiological characteristics of patients during a large citywide- documented outbreak of carbapenem-resistant A. baumannii (CRAb). Methods: Retrospective cross-sectional study that evaluated the information obtained from the official notification system data of CRAb from the Health Department, Porto Alegre, Brazil, in the period of July 1^st, 2007 to December 31^st, 2008. The association among variables was analyzed with SPSS 13.0. Results: A total of 1,260 CRAb from infection (608 [48.3%]) or colonization (652 [51.7%]) were reported in 18 hospitals. Most patients (53.5%) were hospitalized at intensive care units and have been exposed to invasive procedures, but 757 (60.7%) patients had no underlying comorbidity reported. A total of 1,143 (90.7%) patients received some antimicrobial 90 days before CRAb detection and 36.4% received a carbapenem. The outcome was available for 618 (49.0%) patients and 54.3% of them died. The prevalence ratio (PR) of infection was statistically significant for variables admission to public hospitals; trauma and use of antibiotic in previous 90 days.

Conclusion: This study suggests that in the context of an outbreak, baseline comorbidities and previous carbapenem exposure may be less important risk factors for CRAb infection/colonization.