Please use this identifier to cite or link to this item: http://docs.prosentient.com.au/prosentientjspui/handle/1/11251
Title: A 16-year prospective study of community-onset bacteremic Acinetobacter pneumonia: low mortality with appropriate initial empirical antibiotic protocols.
Authors: Davis, Joshua S
McMillan, Mark
Swaminathan, Ashwin
Kelly, John A
Piera, Kim E
Baird, Robert W
Currie, Bart J
Anstey, Nicholas M
Affiliation: The Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University; Department of Infectious Diseases, Royal Darwin Hospital, Darwin, NT, Australia. Electronic address: joshua.davis@menzies.edu.au..
The Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University..
Department of Infectious Diseases, Royal Darwin Hospital, Darwin, NT, Australia; Department of Microbiology, Royal Darwin Hospital, Darwin, NT, Australia..
Department of Infectious Diseases, Royal Darwin Hospital, Darwin, NT, Australia; Department of Microbiology, Royal Darwin Hospital, Darwin, NT, Australia..
The Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University..
Department of Infectious Diseases, Royal Darwin Hospital, Darwin, NT, Australia; Department of Microbiology, Royal Darwin Hospital, Darwin, NT, Australia..
The Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University; Department of Infectious Diseases, Royal Darwin Hospital, Darwin, NT, Australia..
The Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University; Department of Infectious Diseases, Royal Darwin Hospital, Darwin, NT, Australia..
Issue Date: Oct-2014
Citation: Chest 2014-10; 146(4): 1038-1045
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.
URI: http://docs.prosentient.com.au/prosentientjspui/handle/1/11251
DOI: 10.1378/chest.13-3065
Type: Journal Article
Observational Study
Research Support, Non-U.S. Gov't
Subjects: 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
Appears in Collections:NT Health digital library

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