Davis JS; McMillan M; Swaminathan A; Kelly JA; Piera KE; Baird RW; Currie BJ; Anstey NM

Author(s)

Davis JS

McMillan M

Swaminathan A

Kelly JA

Piera KE

Baird RW

Currie BJ

Anstey NM

Publication Date

2014-10

Abstract

The genus Acinetobacter, well known as a nosocomial pathogen, can also cause severe community-onset pneumonia. Previous small case series have suggested fulminant disease and a pooled hospital mortality of > 60%. We conducted a prospective observational study of all episodes of bacteremic, community-onset, and radiologically confirmed pneumonia due to Acinetobacter species at a tertiary referral hospital in tropical Australia from 1997 to 2012 following the introduction of routine empirical treatment protocols covering Acinetobacter. Demographic, clinical, microbiologic, and outcome data were collected. There were 41 episodes of bacteremic community-onset Acinetobacter pneumonia, of which 36 had no indicators suggesting health-care-associated infection. Of these, 38 (93%) were Indigenous Australians, one-half were men, the average age was 44.1 years, and 36 episodes (88%) occurred during the rainy season. All patients had at least one risk factor, with hazardous alcohol intake in 82%. Of the 37 isolates available for molecular speciation, 35 were Acinetobacter baumannii and two were Acinetobacter nosocomialis. All isolates were susceptible in vitro to gentamicin, meropenem, and ciprofloxacin, but only one was fully susceptible to ceftriaxone. ICU admission was required in 80%. All 41 patients received appropriate antibiotics within the first 24 h of admission, and 28- and 90-day mortality were both low at 11%. Community-acquired Acinetobacter pneumonia is a severe disease, with the majority of patients requiring ICU admission. Most patients have risk factors, particularly hazardous alcohol use. Despite this severity, correct initial empirical antibiotic therapy in all patients was associated with low mortality.

Citation

Chest 2014-10; 146(4): 1038-1045

Pubmed ID

https://pubmed.ncbi.nlm.nih.gov/24901292/?otool=iaurydwlib

Link

https://hdl.handle.net/10137/5586

MESH subject

Acinetobacter

Acinetobacter Infections

Adult

Aged

Anti-Bacterial Agents

Australia

Bacteremia

Community-Acquired Infections

Cross Infection

Female

Hospital Mortality

Humans

Male

Middle Aged

Pneumonia, Bacterial

Prospective Studies

Title

A 16-year prospective study of community-onset bacteremic Acinetobacter pneumonia: low mortality with appropriate initial empirical antibiotic protocols.

Type of document

Journal Article

Observational Study

Entity Type

Publication

Author(s)	Davis JS McMillan M Swaminathan A Kelly JA Piera KE Baird RW Currie BJ Anstey NM
Publication Date	2014-10
Abstract	The genus Acinetobacter, well known as a nosocomial pathogen, can also cause severe community-onset pneumonia. Previous small case series have suggested fulminant disease and a pooled hospital mortality of > 60%. We conducted a prospective observational study of all episodes of bacteremic, community-onset, and radiologically confirmed pneumonia due to Acinetobacter species at a tertiary referral hospital in tropical Australia from 1997 to 2012 following the introduction of routine empirical treatment protocols covering Acinetobacter. Demographic, clinical, microbiologic, and outcome data were collected. There were 41 episodes of bacteremic community-onset Acinetobacter pneumonia, of which 36 had no indicators suggesting health-care-associated infection. Of these, 38 (93%) were Indigenous Australians, one-half were men, the average age was 44.1 years, and 36 episodes (88%) occurred during the rainy season. All patients had at least one risk factor, with hazardous alcohol intake in 82%. Of the 37 isolates available for molecular speciation, 35 were Acinetobacter baumannii and two were Acinetobacter nosocomialis. All isolates were susceptible in vitro to gentamicin, meropenem, and ciprofloxacin, but only one was fully susceptible to ceftriaxone. ICU admission was required in 80%. All 41 patients received appropriate antibiotics within the first 24 h of admission, and 28- and 90-day mortality were both low at 11%. Community-acquired Acinetobacter pneumonia is a severe disease, with the majority of patients requiring ICU admission. Most patients have risk factors, particularly hazardous alcohol use. Despite this severity, correct initial empirical antibiotic therapy in all patients was associated with low mortality.
Citation	Chest 2014-10; 146(4): 1038-1045
Pubmed ID	https://pubmed.ncbi.nlm.nih.gov/24901292/?otool=iaurydwlib
Link	https://hdl.handle.net/10137/5586
MESH subject	Acinetobacter Acinetobacter Infections Adult Aged Anti-Bacterial Agents Australia Bacteremia Community-Acquired Infections Cross Infection Female Hospital Mortality Humans Male Middle Aged Pneumonia, Bacterial Prospective Studies
Title	A 16-year prospective study of community-onset bacteremic Acinetobacter pneumonia: low mortality with appropriate initial empirical antibiotic protocols.
Type of document	Journal Article Observational Study
Entity Type	Publication

A 16-year prospective study of community-onset bacteremic Acinetobacter pneumonia: low mortality with appropriate initial empirical antibiotic protocols.

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