Prevalence of Acinetobacter baumannii and Candida auris in Patients Receiving Mechanical Ventilation

Harris, AD; Pineles, L; Johnson, JK; O'Hara, LM; Smith, LL; French, I; Rubin, J; Perlmutter, R; Heller, A; Klein, L; Thoguru, J; Blythe, D; Vaeth, E

doi:10.1001/jama.2023.21083

Sepsis & infection

Prevalence of Acinetobacter baumannii and Candida auris in Patients Receiving Mechanical Ventilation

JAMAPublished 14 Nov 2023Cross-sectional study

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Authors' conclusion

A baumannii, carbapenem-resistant A baumannii, and C auris were common among patients receiving mechanical ventilation in both acute care hospitals and long-term care facilities. Both pathogens were significantly more common in long-term care facilities than in acute care hospitals.

Study context

Population: Patients receiving mechanical ventilation in acute care hospitals and long-term care facilities in Maryland, March–June 2023470 screened for C auris
Participants: 482 patients

Exposure: Long-term care facilities vs acute care hospitals
Long-term care facilitiesn = 18
Acute care hospitalsn = 33reference
Outcome: Prevalence of A baumannii, carbapenem-resistant A baumannii (CRAB), and C auris, stratified by type of facility

Methodological detailsstatewide point prevalence survey, surveillance cultures, All 51 eligible facilities (100%) participated

Statewide point prevalence survey
Surveillance cultures
All 51 eligible facilities (100%) participated

Main finding

As reported in the abstract

Prevalence (all patients)

A baumannii: 148/482

30.7%

Carbapenem-resistant A baumannii (CRAB) among A baumannii: 88/148

59.5%

C auris: 31/470

6.6%

Observational data: associations, not effects.

Further findings

Outcome	← Lower risk with long-term care facilities ←→ Higher risk with long-term care facilities →	RR (95% CI)	P value
Colonization, long-term care facilities vs acute care hospitalsLong-term care facilities vs Acute care hospitals · A baumannii	0.050.21520	7.66 (5.11–11.50)	P < 0.001
Colonization, long-term care facilities vs acute care hospitalsLong-term care facilities vs Acute care hospitals · CRAB	0.050.21520	5.48 (3.38–8.91)	P < 0.001
Colonization, long-term care facilities vs acute care hospitalsLong-term care facilities vs Acute care hospitals · C auris	0.050.21520	1.97 (0.99–3.92)	P = 0.05
	0.050.21520Relative risk (log scale)

C auris-positive patients previously unreported to the Maryland Department of Health

9 patients: 29.0%

Original publication

Prevalence of Acinetobacter baumannii and Candida auris in Patients Receiving Mechanical Ventilation. JAMA. Published 14 November 2023. doi:10.1001/jama.2023.21083

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