Hospital-Acquired Infections Caused by Acinetobacter baumannii: A Comparative Analysis of Risk Factors with Other ESKAPE-E Pathogens in a Third-Level IMSS Hospital in Yucatan Mexico

Background: Acinetobacter baumannii is classified within the ESKAPE-E group of pathogens, recognized for its role in causing severe infections, and is often associated with various healthcare-related infection (HAIs) types, particularly in intensive care units. This opportunistic pathogen is distinguished by its considerable antibiotic resistance and is associated with prolonged hospital stays, high medical costs, and increased mortality rates. Objective: This study investigated factors associated with HAIs caused by A. baumannii, versus other ESKAPE-E pathogens, to identify distinguishing intrinsic and extrinsic factors that guide the control and prevention of HAIs within our hospital. Methods: This study included patients from a Third-Level IMSS Hospital in Mérida, Mexico, between 2018 and 2022, with 54 cases (HAIs caused by A. baumannii) and 108 matched controls (HAIs caused by other ESKAPE-E pathogens). Results: Ventilator-associated pneumonia was the most frequent HAI in both groups, followed by catheter-related bloodstream infections. Comorbidities were more common in patients with HAIs caused by A. baumannii than in those with other ESKAPE-E pathogens. Most patients received antimicrobial treatment before HAIs development. Bivariate analysis showed that comorbidities and prior meropenem and linezolid treatment were significant risk factors, whereas multivariate analysis identified comorbidities and prior meropenem use as risk factors for A. baumannii HAIs versus other ESKAPE-E pathogens. Most A. baumannii isolates were extensively drug-resistant (90.7%), with 84% showing carbapenem resistance. Conclusions: This study highlights the importance of optimizing antimicrobial use and measures to mitigate A. baumannii HAIs. These findings have significant implications for infection control and antimicrobial stewardship in healthcare settings.