A prospective cohort study of the clinical profile of <i>Acinetobacter baumannii</i> infections in Thailand

Abstract Objectives To better define the clinical features of Acinetobacter spp. infection in Northern Thailand, including a comparison of hospital- and community-acquired infections (HAIs and CAIs). Methods A prospective clinical study of Acinetobacter spp. infections at two Northern Thailand hospitals from 2019 to 2022, collecting data on sample sources, patient demographics, comorbidities, antimicrobial resistance profiles, and outcomes. Results Of 129 enrolled 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 hours of admission. Compared to HAIs, 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). Acinetobacter spp. HAIs mainly occurred after admission to ITU (87.7%, p &lt;0.0001) and were more likely to be multidrug-resistant than CAIs (76.3% vs. 34.4%, p &lt;0.0001). Overall, the median length of hospital stay was 27 days and there was a 27.1% in-hospital mortality, which was increased in patients with CVA/brain ( p =0.005), and multidrug-resistant ( p= 0.010) or carbapenem-resistant infections ( p= 0.003). Conclusions These data define the clinical profile of Acinetobacter spp. infections in Northern Thailand, confirming their high mortality and demonstrating CAIs are a significant proportion of all cases.