Acinetobacter baumannii: emergence and spread in Israeli hospitals 1997-2002

Area of Science:

• Infectious Diseases
• Clinical Microbiology
• Hospital Epidemiology

Background:

• Rising incidence of multi-drug-resistant Acinetobacter baumannii bloodstream infections (BSIs) observed in three Israeli hospitals between 1997 and 2002.
• These infections constituted a significant proportion (3.5-18%) of all hospital-acquired BSIs during the study period.

Purpose of the Study:

• To investigate the epidemiology and clinical impact of multi-drug-resistant Acinetobacter baumannii BSIs.
• To highlight the association between carbapenem resistance, consumption, and patient outcomes.

Main Methods:

• Retrospective analysis of hospital-acquired bloodstream infection data.
• Monitoring of antimicrobial resistance patterns and consumption trends.

Main Results:

• A two- to four-fold increase in multi-drug-resistant A. baumannii BSIs was documented.
• Carbapenem resistance rates escalated to 35-54%, correlating with increased carbapenem consumption.
• In-hospital fatality rates for A. baumannii BSIs were high (47-58%) compared to other Gram-negative pathogens.
• A. baumannii spread beyond intensive care units to all hospital wards.

Conclusions:

• Multi-drug-resistant A. baumannii poses a significant and escalating threat in hospital settings.
• The findings underscore the potential for this pathogen to become endemic.
• Vigorous and innovative control measures are imperative to curb the spread of A. baumannii infections.