Acinetobacter baumannii Isolates from COVID-19 Patients in a Hospital Intensive Care Unit: Molecular Typing and Risk Factors
Mariateresa Ceparano; Valentina Baccolini; Giuseppe Migliara; Claudia Isonne; Erika Renzi; Daniela Tufi; Corrado De Vito; Maria De Giusti; Maria Trancassini; Francesco Alessandri; Giancarlo Ceccarelli; Francesco Pugliese; Paolo Villari; Maria Angiulli; Stefania Battellito; Arianna Bellini; Andrea Bongiovanni; Lucilla Caivano; Marta Castellani; Monica Coletti; Alessia Cottarelli; Ludovica D’Agostino; Andrea De Giorgi; Chiara De Marchi; Irma Germani; Dara Giannini; Elisa Mazzeo; Shadi Orlandi; Matteo Piattoli; Eleonora Ricci; Leonardo Maria Siena; Alessandro Territo; Gianluca Vrenna; Stefano Zanni; Carolina Marzuillo
Infections caused by Acinetobacter baumannii represent a major concern for intensive care unit (ICU) patients. However, the epidemiology of these infections among COVID-19 patients has not been fully explored. The aims of this study were (i) to characterize the clonal spread of A. baumannii among COVID-19 patients admitted to the ICU of the Umberto I hospital of Rome during the first year of the pandemic and (ii) to identify risk factors for its acquisition. Isolates were analysed by pulsed-field gel electrophoresis, and a multivariable regression model was constructed. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were calculated. Overall, 193 patients were included, and 102 strains were analysed. All isolates had highly antibiotic-resistant profiles and derived from two genotypes. The cumulative incidence of A. baumannii acquisition (colonization or infection) was 36.8%. Patients with A. baumannii had higher mortality and length of stay. Multivariable analysis showed that previous carbapenem use was the only risk factor associated with A. baumannii acquisition (aOR: 4.15, 95% CI: 1.78&ndash:9.64). We documented substantial A. baumannii infections and colonization and high levels of clonal transmission. Given the limited treatment options, effective prevention and containment strategies to limit the spread of A. baumannii should be implemented.
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