Multidrug-Resistant Acinetobacter baumannii

摘要

To the Editor: In the January 2007 issue of Emerging Infectious Diseases, Sunenshine et al. (1) de-scribed their fi nding of an indepen-dent association between patients with multidrug-resistant (MDR) Acineto-bacter infection and increased hospital and intensive care unit (ICU) length of stay compared with that for patients with antimicrobial drug–susceptible Acinetobacter infection. The authors did not, however, fi nd a statistically signifi cant difference in mortality rates between the 2 groups of patients.Acinetobacter infections fre-quently occur in severely ill ICU pa-tients with other chronic illnesses or prolonged hospitalizations. We ana-lyzed data for 27 neutropenic cancer patients with A. baumannii–associated bacteremia (15 with MDR and 12 with drug-susceptible A. baumannii infec-tions) but no other chronic illness. We considered A. baumannii strains to be MDR if they were resistant to amika-cin, meropenem, and cipro. oxacin. Univariate analysis (Epi Info 2000; Centers for Disease Control and Pre-vention, Atlanta, GA, USA) showed that most of the bacteremic episodes were associated with certain risk fac-tors, such as catheter insertion, neu-tropenia, acute leukemia, and pre-vious prophylactic treatment with quinolones or therapeutic treatment with cephalosporins or carbapenems (meropenem or imipenem) (Table).