title: Acinetobacter bacteraemia in Thailand: evidence for infections outside the hospital setting.
abstract: Acinetobacter is a well-recognized nosocomial pathogen. Previous reports of community-associated Acinetobacter infections have lacked clear case definitions and assessment of healthcare-associated (HCA) risk factors. We identified Acinetobacter bacteraemia cases from blood cultures obtained <3 days after hospitalization in rural Thailand and performed medical record reviews to assess HCA risk factors in the previous year and compare clinical and microbiological characteristics between cases with and without HCA risk factors. Of 72 Acinetobacter cases, 32 (44%) had no HCA risk factors. Compared to HCA infections, non-HCA infections were more often caused by Acinetobacter species other than calcoaceticus-baumannii complex species and by antibiotic-susceptible organisms. Despite similar symptoms, the case-fatality proportion was lower in non-HCA than HCA cases (9% vs. 45%, P < 0·01). Clinicians should be aware of Acinetobacter as a potential cause of community-associated infections in Thailand; prospective studies are needed to improve understanding of associated risk factors and disease burden.
authors.affiliation: Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA.
authors.forename: K A
authors.initials: KA
authors.lastname: Porter
authors.affiliation: International Emerging Infections Program, Global Disease Detection Regional Center, Thailand Ministry of Public Health, United States Centers for Disease Control and Prevention (CDC) Collaboration, Nonthaburi, Thailand.
authors.forename: J
authors.initials: J
authors.lastname: Rhodes
authors.affiliation: National Institute of Health, Ministry of Public Health, Nonthaburi, Thailand.
authors.forename: S
authors.initials: S
authors.lastname: Dejsirilert
authors.affiliation: International Emerging Infections Program, Global Disease Detection Regional Center, Thailand Ministry of Public Health, United States Centers for Disease Control and Prevention (CDC) Collaboration, Nonthaburi, Thailand.
authors.forename: S
authors.initials: S
authors.lastname: Henchaichon
authors.affiliation: International Emerging Infections Program, Global Disease Detection Regional Center, Thailand Ministry of Public Health, United States Centers for Disease Control and Prevention (CDC) Collaboration, Nonthaburi, Thailand.
authors.forename: D
authors.initials: D
authors.lastname: Siludjai
authors.affiliation: International Emerging Infections Program, Global Disease Detection Regional Center, Thailand Ministry of Public Health, United States Centers for Disease Control and Prevention (CDC) Collaboration, Nonthaburi, Thailand.
authors.forename: S
authors.initials: S
authors.lastname: Thamthitiwat
authors.affiliation: International Emerging Infections Program, Global Disease Detection Regional Center, Thailand Ministry of Public Health, United States Centers for Disease Control and Prevention (CDC) Collaboration, Nonthaburi, Thailand.
authors.forename: P
authors.initials: P
authors.lastname: Prapasiri
authors.affiliation: International Emerging Infections Program, Global Disease Detection Regional Center, Thailand Ministry of Public Health, United States Centers for Disease Control and Prevention (CDC) Collaboration, Nonthaburi, Thailand.
authors.forename: P
authors.initials: P
authors.lastname: Jorakate
authors.affiliation: International Emerging Infections Program, Global Disease Detection Regional Center, Thailand Ministry of Public Health, United States Centers for Disease Control and Prevention (CDC) Collaboration, Nonthaburi, Thailand.
authors.forename: A
authors.initials: A
authors.lastname: Kaewpan
authors.affiliation: International Emerging Infections Program, Global Disease Detection Regional Center, Thailand Ministry of Public Health, United States Centers for Disease Control and Prevention (CDC) Collaboration, Nonthaburi, Thailand.
authors.forename: L F
authors.initials: LF
authors.lastname: Peruski
authors.affiliation: National Institute of Health, Ministry of Public Health, Nonthaburi, Thailand.
authors.forename: A
authors.initials: A
authors.lastname: Kerdsin
authors.affiliation: Phonsawan District Hospital, Ministry of Public Health, Nakhon Phanom, Thailand.
authors.forename: K
authors.initials: K
authors.lastname: Prasert
authors.affiliation: Sa Kaeo Crown Prince Hospital, Ministry of Public Health, Sa Kaeo, Thailand.
authors.forename: S
authors.initials: S
authors.lastname: Yuenprakone
authors.affiliation: International Emerging Infections Program, Global Disease Detection Regional Center, Thailand Ministry of Public Health, United States Centers for Disease Control and Prevention (CDC) Collaboration, Nonthaburi, Thailand.
authors.forename: S A
authors.initials: SA
authors.lastname: Maloney
authors.affiliation: International Emerging Infections Program, Global Disease Detection Regional Center, Thailand Ministry of Public Health, United States Centers for Disease Control and Prevention (CDC) Collaboration, Nonthaburi, Thailand.
authors.forename: H C
authors.initials: HC
authors.lastname: Baggett
mesh_terms: D000151:Acinetobacter Infections / Q000453:epidemiology*; D000293:Adolescent; D000328:Adult; D000368:Aged; D016470:Bacteremia / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000453:epidemiology / Q000382:microbiology*; D003428:Cross Infection / Q000453:epidemiology; D005260:Female; D006761:Hospitals; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D012307:Risk Factors; D013785:Thailand / Q000453:epidemiology; D055815:Young Adult