A prospective cohort study of the clinical profile of Acinetobacter baumannii and Acinetobacter nosocomialis infections in Thailand

OBJECTIVES: To define the clinical features of Acinetobacter spp. infection in Northern Thailand, including a comparison of hospital-acquired culture positives (HACP) and community-acquired infections (CAIs). METHODS: A prospective clinical study of Acinetobacter spp. infections at two Northern Thailand hospitals from 2019 to 2022. RESULTS: Of 129 enroled patients, 81.4% had Acinetobacter spp. isolated from a respiratory sample. A significant minority (25.6%) of infections were CAIs, 33.3% of which were admitted to ITU within 24 h of admission. Compared to HACPs, CAIs were significantly more likely to be caused by blood (15.2%, p=0.0258), wound (21.2%, p=0.0120), or urine infections (12.1%, p=0.0370). A high proportion of Acinetobacter spp. HACPs occurred in patients admitted to ITU (52.1%) and were more likely to be multidrug-resistant than CAIs (76.3% vs. 34.4%, p<0.0001). Overall, the median length of hospital stay was 27 days and there was a 27.1% in-hospital mortality. Mortality was increased in patients with chronic neurological disease (odds ratio 3.2, p=0.017) or infected with multidrug-resistant strains (odds ratio 4.8, p=0.002). CONCLUSIONS: These data define the clinical profile of Acinetobacter spp. infections in Northern Thailand, confirming their high mortality and demonstrating CAIs cause a significant proportion of all cases.