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Acinetobacter baumannii Isolates from COVID-19 Patients in a Hospital Intensive Care Unit: Molecular Typing and Risk Factors. 2022
Mariateresa Ceparano, and
Valentina Baccolini, and
Giuseppe Migliara, and
Claudia Isonne, and
Erika Renzi, and
Daniela Tufi, and
Corrado De Vito, and
Maria De Giusti, and
Maria Trancassini, and
Francesco Alessandri, and
Giancarlo Ceccarelli, and
Francesco Pugliese, and
Paolo Villari, and
Maria Angiulli, and
Stefania Battellito, and
Arianna Bellini, and
Andrea Bongiovanni, and
Lucilla Caivano, and
Marta Castellani, and
Monica Coletti, and
Alessia Cottarelli, and
Ludovica D'Agostino, and
Andrea De Giorgi, and
Chiara De Marchi, and
Irma Germani, and
Dara Giannini, and
Elisa Mazzeo, and
Shadi Orlandi, and
Matteo Piattoli, and
Eleonora Ricci, and
Leonardo Maria Siena, and
Alessandro Territo, and
Gianluca Vrenna, and
Stefano Zanni, and
Carolina Marzuillo
Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy.
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: 1.78-9.64). 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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