News: Infectious disease study reveals significant burden of A. baumannii hospitalizations

A recent Springer Nature study found an increase in Acinetobacter baumannii infections between 2018 and 2021 and carbapenem-resistant A. baumannii (CRAB) infections between 2018 and 2022, JustCoding reported. The presence of the bacteria was identified in 1% of hospitalized United States patients, and over one third of A. baumannii cases were CRAB, designated by the World Health Organization (WHO) as a critical pathogen in need of new antibiotics.

In a report issued by the National Healthcare Safety Network, A. baumannii is a pathogen considered to be a leading cause of healthcare-associated infections, particularly in individuals who are hospitalized in intensive care units, using ventilators or catheters, immunocompromised, or recovering from surgery or trauma. The pathogen is gram-negative, meaning it has a specific cell wall structure that can make it harder for the immune system to destroy and are non-receptive to antibiotics.

Carbapenems are a class of powerful, broad-spectrum antibiotics often used as a last resort when other antibiotics fail. When A. baumannii becomes resistant to carbapenems, it is labeled as CRAB. This type of infection is a major health concern because it is difficult to treat, spreads easily in healthcare settings, and is associated with high mortality rates, especially in critically ill patients. Patients with CRAB tend to have increased mortality risk (up to 55% all-cause mortality), longer hospital stays, and lower probability of being discharged home.

The study found that A. baumannii cases per 100 hospitalization encounters grew from 1.22 in 2018 to 1.33 in 2021, before dropping to 1.17 in 2022. The CRAB incidence rate—based on non-susceptibility to either doripenem, imipenem, or meropenem—grew from 0.39 cases per 100 hospitalization encounters in 2018 to 0.53 cases in 2022.

Data outcomes also showed that patients with CRAB were more likely to reside in an intensive care unit (62.4%), be transferred to another healthcare facility (38.6%), and die during their hospitalization (20.5%), compared to those with carbapenem-susceptible A. baumannii. They were less likely to be discharged home (18.0%) as well.

Although the CDC and WHO have labeled CRAB as an urgent threat globally, patients with CRAB infections currently have very limited treatment options, commonly relying on older antibiotics.

Editor’s note: This article was originally published in JustCoding.