title: Risk factors for carbapenem-resistant Acinetobacter baumannii infections at a tertiary care hospital in New Caledonia, South Pacific.
abstract: In New Caledonia, South Pacific, Acinetobacter baumannii is a nosocomial pathogen. OXA-23 carbapenem-resistant A. baumannii (CRAB) has been ranked third among all multidrug-resistant (MDR) bacteria at the main hospital of Nouméa in New Caledonia (24.8%, 50/202 isolates). In the present study, risk factors and outcomes for 50 patients with CRAB infection were compared with those of 152 patients infected with other MDR bacteria. Independent risk factors for infection with CRAB were respiratory ward admission (odds ratio 2.8, 95% confidence interval 1.1-7.1) and previous treatment with quinolones, β-lactams and anti-MRSA antibiotics. The 30-day mortality was higher for CRAB infections compared with other MDR infections (14% vs 3.3%, p = 0.006). These findings highlight the importance of knowing specific local characteristics relating to the ecology and patterns of resistance of MDR bacteria so as to avoid the emergence of unexpected pan-resistant bacteria.
authors.affiliation: Institut Pasteur de Nouvelle Calédonie, Nouméa, New Caledonia. slehello@pasteur.fr
authors.forename: Simon
authors.initials: S
authors.lastname: Le Hello
authors.forename: Virginie
authors.initials: V
authors.lastname: Falcot
authors.forename: Flore
authors.initials: F
authors.lastname: Lacassin
authors.forename: Marc
authors.initials: M
authors.lastname: Mikulski
authors.forename: Francine
authors.initials: F
authors.lastname: Baumann
mesh_terms: D000151:Acinetobacter Infections / Q000453:epidemiology* / Q000382:microbiology* / Q000401:mortality; D040981:Acinetobacter baumannii / Q000187:drug effects* / Q000302:isolation & purification*; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D015780:Carbapenems / Q000494:pharmacology*; D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology / Q000401:mortality; D005260:Female; D006761:Hospitals; D006801:Humans; D008297:Male; D008875:Middle Aged; D009510:New Caledonia / Q000453:epidemiology; D012307:Risk Factors; D016896:Treatment Outcome; D018440:beta-Lactam Resistance
chemical_list: D000900:Anti-Bacterial Agents; D015780:Carbapenems