title: Clinical and Epidemiological Significance of Carbapenem Resistance in Acinetobacter baumannii Infections.
abstract: Carbapenems are considered the treatment of choice for Acinetobacter baumannii infections. Many facilities implement preventive measures toward only carbapenem-resistant A. baumannii (CRAB). However, the independent role of the carbapenem resistance determinant on patient outcomes remains controversial. In a 6-year analysis of adults with A. baumannii bloodstream infection (BSI), the outcomes of 149 CRAB isolates were compared to those of 91 patients with carbapenem-susceptible A. baumannii In bivariable analyses, CRAB BSIs were significantly associated with worse outcomes and with a delay in the initiation of appropriate antimicrobial therapy (DAAT). However, in multivariable analyses, carbapenem resistance status was no longer associated with poor outcomes, while DAAT remained an independent predictor. The epidemiological significance of A. baumannii should not be determined by its resistance to carbapenems.
authors.affiliation: Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Ruthy
authors.initials: R
authors.lastname: Tal-Jasper
authors.affiliation: Department of Internal Medicine D, Shaare Zedek Medical Center, Jerusalem, Israel.
authors.forename: David E
authors.initials: DE
authors.lastname: Katz
authors.affiliation: Unit of Infectious Diseases, Assaf Harofeh Medical Center, Zerifin, Israel.
authors.forename: Nadav
authors.initials: N
authors.lastname: Amrami
authors.affiliation: Unit of Infectious Diseases, Assaf Harofeh Medical Center, Zerifin, Israel.
authors.forename: Dor
authors.initials: D
authors.lastname: Ravid
authors.affiliation: Unit of Infectious Diseases, Assaf Harofeh Medical Center, Zerifin, Israel.
authors.forename: Dori
authors.initials: D
authors.lastname: Avivi
authors.affiliation: Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel Unit of Infectious Diseases, Assaf Harofeh Medical Center, Zerifin, Israel.
authors.forename: Ronit
authors.initials: R
authors.lastname: Zaidenstein
authors.affiliation: Clinical Microbiology Laboratory, Assaf Harofeh Medical Center, Zerifin, Israel.
authors.forename: Tsilia
authors.initials: T
authors.lastname: Lazarovitch
authors.affiliation: Unit of Infectious Diseases, Assaf Harofeh Medical Center, Zerifin, Israel.
authors.forename: Mor
authors.initials: M
authors.lastname: Dadon
authors.affiliation: Division of Infectious Diseases, Detroit Medical Center, Wayne State University, Detroit, Michigan, USA.
authors.forename: Keith S
authors.initials: KS
authors.lastname: Kaye
authors.affiliation: Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel Unit of Infectious Diseases, Assaf Harofeh Medical Center, Zerifin, Israel drormarchaim@gmail.com.
authors.forename: Dror
authors.initials: D
authors.lastname: Marchaim
mesh_terms: D000151:Acinetobacter Infections / Q000188:drug therapy / Q000453:epidemiology*; D040981:Acinetobacter baumannii / Q000187:drug effects* / Q000472:pathogenicity*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D015780:Carbapenems / Q000627:therapeutic use*; D024881:Drug Resistance, Bacterial / Q000235:genetics; D006801:Humans; D053208:Kaplan-Meier Estimate; D008826:Microbial Sensitivity Tests; D015999:Multivariate Analysis; D012336:RNA, Ribosomal, 16S / Q000235:genetics; D012189:Retrospective Studies
chemical_list: D000900:Anti-Bacterial Agents; D015780:Carbapenems; D012336:RNA, Ribosomal, 16S