Acinetobacterbacteraemia in Thailand: evidence for infections outside the hospital setting

Abstract

SUMMARYAcinetobacteris a well-recognized nosocomial pathogen. Previous reports of community-associatedAcinetobacterinfections have lacked clear case definitions and assessment of healthcare-associated (HCA) risk factors. We identifiedAcinetobacterbacteraemia cases from blood cultures obtained <3 days after hospitalization in rural Thailand and performed medical record reviews to assess HCA risk factors in the previous year and compare clinical and microbiological characteristics between cases with and without HCA risk factors. Of 72Acinetobactercases, 32 (44%) had no HCA risk factors. Compared to HCA infections, non-HCA infections were more often caused byAcinetobacterspecies other thancalcoaceticus–baumanniicomplex species and by antibiotic-susceptible organisms. Despite similar symptoms, the case-fatality proportion was lower in non-HCA than HCA cases (9%vs. 45%,P < 0·01). Clinicians should be aware ofAcinetobacteras a potential cause of community-associated infections in Thailand; prospective studies are needed to improve understanding of associated risk factors and disease burden.