{"id":24865,"date":"2023-11-27T04:46:00","date_gmt":"2023-11-26T20:46:00","guid":{"rendered":"http:\/\/csccm.org.cn\/?p=24865"},"modified":"2023-11-27T05:38:34","modified_gmt":"2023-11-26T21:38:34","slug":"jama%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87%ef%bc%9a%e6%8e%a5%e5%8f%97%e6%9c%ba%e6%a2%b0%e9%80%9a%e6%b0%94%e6%82%a3%e8%80%85%e9%b2%8d%e6%9b%bc%e4%b8%8d%e5%8a%a8%e6%9d%86%e8%8f%8c%e5%92%8c%e8%80%b3","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=24865","title":{"rendered":"[JAMA\u53d1\u8868\u8bba\u6587]\uff1a\u63a5\u53d7\u673a\u68b0\u901a\u6c14\u60a3\u8005\u9c8d\u66fc\u4e0d\u52a8\u6746\u83cc\u548c\u8033\u5ff5\u73e0\u83cc\u7684\u7f79\u60a3\u7387"},"content":{"rendered":"\n

Brief Report <\/p>\n\n\n\n

October 12, 2023<\/p>\n\n\n\n

Prevalence of\u00a0Acinetobacter baumannii<\/em> and\u00a0Candida auris\u00a0<\/em>in Patients Receiving Mechanical Ventilation<\/h1>\n\n\n\n

Anthony D.\u00a0Harris,\u00a0Lisa\u00a0Pineles,\u00a0J. Kristie\u00a0Johnson,\u00a0et al<\/h3>\n\n\n\n

JAMA.\u00a0<\/em>Published online October 12, 2023. doi:10.1001\/jama.2023.21083<\/h3>\n\n\n\n

<\/a>Key Points<\/p>\n\n\n\n

Question<\/strong>  What is the statewide prevalence of 2 emerging pathogens, Acinetobacter baumannii <\/em>and Candida auris,<\/em> among patients receiving mechanical ventilation?<\/p>\n\n\n\n

Findings<\/strong>  A baumannii<\/em> was identified in 30.7%, carbapenem-resistant A baumannii<\/em> (CRAB) in 59.5% of those samples, and Candida auris<\/em> was identified in 6.6% of all patients receiving mechanical ventilation in Maryland. Patients in long-term care facilities were more likely to be colonized with A baumannii<\/em>, CRAB, and C auris<\/em> compared with patients in acute care facilities.<\/p>\n\n\n\n

Meaning<\/strong>  This study should be repeated in other US states to determine the burden of these pathogens among patients receiving mechanical ventilation. Increased surveillance and prevention efforts should be directed at long-term care facilities.<\/a><\/p>\n\n\n\n

Abstract<\/p>\n\n\n\n

Importance<\/strong>  To date, only 1 statewide prevalence survey has been performed for Acinetobacter baumannii<\/em> (2009) in the US, and no statewide prevalence survey has been performed for Candida auris<\/em>, making the current burden of these emerging pathogens unknown.<\/p>\n\n\n\n

Objective<\/strong>  To determine the prevalence of A baumannii<\/em> and C auris<\/em> among patients receiving mechanical ventilation in Maryland.<\/p>\n\n\n\n

Design, Setting, and Participants<\/strong>  The Maryland Multi-Drug Resistant Organism Prevention Collaborative performed a statewide cross-sectional point prevalence of patients receiving mechanical ventilation admitted to acute care hospitals (n\u2009=\u200933) and long-term care facilities (n\u2009=\u200918) between March 7, 2023, and June 8, 2023. Surveillance cultures (sputum, perianal, arm\/leg, and axilla\/groin) were obtained from all patients receiving mechanical ventilation. Sputum, perianal, and arm\/leg cultures were tested for A baumannii<\/em> and antibiotic susceptibility testing was performed. Axilla\/groin cultures were tested by polymerase chain reaction for C auris<\/em>.<\/p>\n\n\n\n

Main Outcomes and Measures<\/strong>  Prevalence of A baumannii<\/em>, carbapenem-resistant A baumannii<\/em> (CRAB), and C auris<\/em>. Prevalence was stratified by type of facility.<\/p>\n\n\n\n

Results<\/strong>\u00a0\u00a0All 51 eligible health care facilities (100%) participated in the survey. A total of 482 patients receiving mechanical ventilation were screened for\u00a0A baumannii<\/em>\u00a0and 470 were screened for\u00a0C auris<\/em>. Among the 482 patients who had samples collected, 30.7% (148\/482) grew\u00a0A baumannii<\/em>, 88 of the 148 (59.5%) of these\u00a0A baumannii\u00a0<\/em>were CRAB, and\u00a0C auris<\/em>\u00a0was identified in 31 of 470 (6.6%). Patients in long-term care facilities were more likely to be colonized with\u00a0A baumannii<\/em>\u00a0(relative risk [RR], 7.66 [95% CI, 5.11-11.50],\u00a0P<\/em>\u2009<\u2009.001), CRAB (RR, 5.48 [95% CI, 3.38-8.91],\u00a0P<\/em>\u2009<\u2009.001), and\u00a0C auris<\/em>\u00a0(RR, 1.97 [95% CI, 0.99-3.92],\u00a0P<\/em>\u2009=\u2009.05) compared with patients in acute care hospitals. Nine patients (29.0%) with cultures positive for\u00a0C auris<\/em>\u00a0were previously unreported to the Maryland Department of Health.<\/p>\n\n\n\n

\"\"\/<\/figure>\n\n\n\n
\"\"\/<\/figure>\n\n\n\n

Conclusions<\/strong>  A baumannii<\/em>, carbapenem-resistant A baumannii<\/em>, and C auris<\/em> were common among patients receiving mechanical ventilation in both acute care hospitals and long-term care facilities. Both pathogens were significantly more common in long-term care facilities than in acute care hospitals. Patients receiving mechanical ventilation in long-term care facilities are a high-risk population for emerging pathogens, and surveillance and prevention efforts should be targeted to these facilities.<\/p>\n","protected":false},"excerpt":{"rendered":"

Brief Report  October 12, 2023 Prevalenc […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/24865"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=24865"}],"version-history":[{"count":1,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/24865\/revisions"}],"predecessor-version":[{"id":24866,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/24865\/revisions\/24866"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=24865"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=24865"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=24865"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}