title: Comparison between bacteremia caused by carbapenem resistant Acinetobacter baumannii and Acinetobacter nosocomialis.
abstract: BACKGROUND
  It is unknown whether there are differences between bacteremia caused by carbapenem resistant Acinetobacter baumannii (CRAB) and carbapenem resistant Acinetobacter nosocomialis (CRAN). This study aims to investigate the differences, especially in clinical outcomes, between patients with bacteremia caused by CRAB or CRAN.
  
  
  METHODS
  This is a 9-year retrospective study comparing the clinical manifestations, antimicrobial susceptibilities, and clinical outcomes of 71 patients with CRAB bacteremia and 64 patients with CRAN bacteremia.
  
  
  RESULTS
  Patients with CRAB were more likely to have hematologic malignancies and presented with more shock episodes than those with CRAN. CRAB isolates were more resistant to various classes of antimicrobials except colistin, and therefore the patients with CRAB bacteremia were more likely to receive inappropriate antimicrobial therapies. The 14-day mortality was significantly higher in patients with CRAB (40.8% vs. 14.1%; p = 0.001), and in this study, acquisition of CRAB was identified as an independent risk factor for mortality (odds ratio = 4.003; 95% confidence interval = 1.566-10.231; p = 0.004).
  
  
  CONCLUSIONS
  CRAB and CRAN bacteremia are different in clinical characteristics, antimicrobial susceptibilities, and mortality rates. Genomic species identification should be performed in the study of carbapenem resistant Acinetobacters to better delineate the role of different species.
authors.affiliation: Division of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical, Center, Taipei, Taiwan.
authors.forename: Ya-Sung
authors.initials: YS
authors.lastname: Yang
authors.forename: Yi-Tzu
authors.initials: YT
authors.lastname: Lee
authors.forename: Wen-Chiuan
authors.initials: WC
authors.lastname: Tsai
authors.forename: Shu-Chen
authors.initials: SC
authors.lastname: Kuo
authors.forename: Jun-Ren
authors.initials: JR
authors.lastname: Sun
authors.forename: Chin-Hsuan
authors.initials: CH
authors.lastname: Yang
authors.forename: Te-Li
authors.initials: TL
authors.lastname: Chen
authors.forename: Jung-Chung
authors.initials: JC
authors.lastname: Lin
authors.forename: Chang-Phone
authors.initials: CP
authors.lastname: Fung
authors.forename: Feng-Yee
authors.initials: FY
authors.lastname: Chang
mesh_terms: D000150:Acinetobacter / Q000145:classification* / Q000187:drug effects / Q000302:isolation & purification; D000151:Acinetobacter Infections / Q000453:epidemiology / Q000382:microbiology*; D040981:Acinetobacter baumannii / Q000187:drug effects / Q000302:isolation & purification; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D016470:Bacteremia / Q000453:epidemiology / Q000382:microbiology*; D015780:Carbapenems / Q000494:pharmacology*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008826:Microbial Sensitivity Tests; D012189:Retrospective Studies; D012307:Risk Factors; D018709:Statistics, Nonparametric; D018440:beta-Lactam Resistance
chemical_list: D000900:Anti-Bacterial Agents; D015780:Carbapenems