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Whole-Genome Sequencing to Differentiate Relapse From Reinfection in Community-Onset Bacteremic Acinetobacter

Ella M Meumann1,2, Nicholas M Anstey1,2, Bart J Currie1,2

  • 1Global and Tropical Health Division, Menzies School of Health Research, Darwin, Australia.

Open Forum Infectious Diseases
|July 9, 2019
PubMed

Insights

Community-onset Acinetobacter baumannii pneumonia recurred in 10% of patients. Ongoing hazardous alcohol intake was linked to reinfection, not relapse, confirmed by whole-genome sequencing. This highlights susceptibility in affected individuals.

Area of Science:

  • Infectious Diseases
  • Microbiology
  • Genomics

Background:

  • Community-onset pneumonia caused by Acinetobacter baumannii can lead to recurrent infections.
  • Hazardous alcohol intake is a potential risk factor for severe infections and complications.
  • Understanding the mechanisms of pneumonia recurrence is crucial for effective treatment and prevention.

Purpose of the Study:

  • To investigate the incidence and mechanisms of recurrent bacteremic Acinetobacter baumannii pneumonia in a prospective cohort.
  • To determine if recurrence is due to relapse of the initial infection or reinfection with a new strain.
  • To explore the role of ongoing hazardous alcohol intake in recurrence.

Main Methods:

  • Prospective follow-up of 30 patients with community-onset bacteremic Acinetobacter baumannii pneumonia.
  • Whole-genome sequencing of paired bacterial isolates from initial and recurrent episodes.
  • Phylogenetic analysis to compare genetic relatedness of recurrent and preceding strains.

Main Results:

  • Recurrence of Acinetobacter baumannii pneumonia was observed in 3 of 30 (10%) patients.
  • All recurrent cases were associated with ongoing hazardous alcohol intake.
  • Phylogenetic analysis revealed distinctness between initial and recurrent strains, indicating reinfection.

Conclusions:

  • Recurrent Acinetobacter baumannii pneumonia in this cohort was attributed to reinfection rather than relapse.
  • Ongoing hazardous alcohol intake appears to be a significant risk factor for reinfection in susceptible individuals.
  • Further research is warranted to elucidate the host factors contributing to susceptibility after initial infection.
Keywords:
Acinetobacter baumanniicommunity-acquired pneumoniarecurrencerelapsewhole-genome sequencing

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