{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T01:39:23Z","timestamp":1777513163397,"version":"3.51.4"},"reference-count":20,"publisher":"Cambridge University Press (CUP)","issue":"3","license":[{"start":{"date-parts":[[2020,9,30]],"date-time":"2020-09-30T00:00:00Z","timestamp":1601424000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S0899823X2000450X_as1\"><jats:title>Objective:<\/jats:title><jats:p>Although infections caused by <jats:italic>Acinetobacter baumannii<\/jats:italic> are often healthcare-acquired, difficult to treat, and associated with high mortality, epidemiologic data for this organism are limited. We describe the epidemiology, clinical characteristics, and outcomes for patients with extensively drug-resistant <jats:italic>Acinetobacter baumannii<\/jats:italic> (XDRAB).<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X2000450X_as2\"><jats:title>Design:<\/jats:title><jats:p>Retrospective cohort study<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X2000450X_as3\"><jats:title>Setting:<\/jats:title><jats:p>Department of Veterans\u2019 Affairs Medical Centers (VAMCs)<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X2000450X_as4\"><jats:title>Participants:<\/jats:title><jats:p>Patients with XDRAB cultures (defined as nonsusceptible to at least 1 agent in all but 2 or fewer classes) at VAMCs between 2012 and 2018.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X2000450X_as5\"><jats:title>Methods:<\/jats:title><jats:p>Microbiology and clinical data was extracted from national VA datasets. We used descriptive statistics to summarize patient characteristics and outcomes and bivariate analyses to compare outcomes by culture source.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X2000450X_as6\"><jats:title>Results:<\/jats:title><jats:p>Among 11,546 patients with 15,364 <jats:italic>A. baumannii<\/jats:italic> cultures, 408 (3.5%) patients had 667 (4.3%) XDRAB cultures. Patients with XDRAB were older (mean age, 68 years; SD, 12.2) with median Charlson index 3 (interquartile range, 1\u20135). Respiratory specimens (n = 244, 36.6%) and urine samples (n = 187, 28%) were the most frequent sources; the greatest proportion of patients were from the South (n = 162, 39.7%). Most patients had had antibiotic exposures (n = 362, 88.7%) and hospital or long-term care admissions (n = 331, 81%) in the prior 90 days. Polymyxins, tigecycline, and minocycline demonstrated the highest susceptibility. Also, 30-day mortality (n = 96, 23.5%) and 1-year mortality (n = 199, 48.8%) were high, with significantly higher mortality in patients with blood cultures.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X2000450X_as7\"><jats:title>Conclusions:<\/jats:title><jats:p>The proportion of <jats:italic>Acinetobacter baumannii<\/jats:italic> in the VA that was XDR was low, but treatment options are extremely limited and clinical outcomes were poor. Prevention of healthcare-associated XDRAB infection should remain a priority, and novel antibiotics for XDRAB treatment are urgently needed.<\/jats:p><\/jats:sec>","DOI":"10.1017\/ice.2020.450","type":"journal-article","created":{"date-parts":[[2020,9,30]],"date-time":"2020-09-30T06:14:32Z","timestamp":1601446472000},"page":"305-310","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":17,"title":["Epidemiology and clinical outcomes associated with extensively drug-resistant (XDR) <i>Acinetobacter<\/i> in US Veterans\u2019 Affairs (VA) medical centers"],"prefix":"10.1017","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1919-9238","authenticated-orcid":false,"given":"Margaret A.","family":"Fitzpatrick","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katie J.","family":"Suda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Linda","family":"Poggensee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amanda","family":"Vivo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marissa","family":"Wirth","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Geneva","family":"Wilson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"Evans","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charlesnika T.","family":"Evans","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2020,9,30]]},"reference":[{"key":"S0899823X2000450X_ref16","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciw423"},{"key":"S0899823X2000450X_ref12","unstructured":"12. Department of Veterans\u2019 Affairs, Office of Rural Health website. www.ruralhealth.va.gov\/aboutus\/ruralvets.asp. Published 2018. Accessed July 10, 2018."},{"key":"S0899823X2000450X_ref4","doi-asserted-by":"publisher","DOI":"10.1186\/cc5911"},{"key":"S0899823X2000450X_ref17","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2015.12480"},{"key":"S0899823X2000450X_ref3","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2017.06.016"},{"key":"S0899823X2000450X_ref8","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.00042-16"},{"key":"S0899823X2000450X_ref11","doi-asserted-by":"publisher","DOI":"10.1016\/0021-9681(87)90171-8"},{"key":"S0899823X2000450X_ref14","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2016.174"},{"key":"S0899823X2000450X_ref19","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.02083-16"},{"key":"S0899823X2000450X_ref9","doi-asserted-by":"publisher","DOI":"10.1016\/j.jgar.2018.02.006"},{"key":"S0899823X2000450X_ref15","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1914433"},{"key":"S0899823X2000450X_ref6","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-0691.2011.03570.x"},{"key":"S0899823X2000450X_ref13","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2016.145"},{"key":"S0899823X2000450X_ref10","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000012278"},{"key":"S0899823X2000450X_ref7","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2019.296"},{"key":"S0899823X2000450X_ref18","doi-asserted-by":"publisher","DOI":"10.1007\/s40265-017-0851-9"},{"key":"S0899823X2000450X_ref20","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(20)30178-X"},{"key":"S0899823X2000450X_ref2","doi-asserted-by":"publisher","DOI":"10.3201\/eid2404.171461"},{"key":"S0899823X2000450X_ref1","unstructured":"1. US Department of Health and Human Services. Antibiotic resistance threats in the United States, 2019. Centers for Disease Control and Prevention website. https:\/\/www.cdc.gov\/drugresistance\/biggest-threats.html. Published 2019. Accessed June 2, 2020."},{"key":"S0899823X2000450X_ref5","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2014.09.004"}],"container-title":["Infection Control &amp; Hospital Epidemiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0899823X2000450X","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,3,10]],"date-time":"2021-03-10T09:01:20Z","timestamp":1615366880000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0899823X2000450X\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,9,30]]},"references-count":20,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2021,3]]}},"alternative-id":["S0899823X2000450X"],"URL":"https:\/\/doi.org\/10.1017\/ice.2020.450","relation":{},"ISSN":["0899-823X","1559-6834"],"issn-type":[{"value":"0899-823X","type":"print"},{"value":"1559-6834","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,9,30]]},"assertion":[{"value":"\u00a9 2020 by The Society for Healthcare Epidemiology of America. All rights reserved.","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}}]}}