Assessing the Burden of Acinetobacter baumannii in Maryland: A statewide cross-sectional period prevalence survey

Objective: To determine the prevalence of Acinetobacter baumannii, an important healthcare-associated pathogen, among mechanically ventilated patients in Maryland. Design: The Maryland MDRO Prevention Collaborative performed a statewide cross-sectional active surveillance survey of mechanically ventilated patients residing in acute care and long-term care (LTC) facilities. Surveillance cultures (sputum and perianal) were obtained from all mechanically ventilated inpatients at participating facilities during a 2-week period. Setting: All healthcare facilities in Maryland that provide care for mechanically ventilated patients were invited to participate. Patients: Mechanically ventilated patients, known to be at high risk for colonization and infection with A. baumannii, were included. Results: Seventy percent (40/57) of all eligible healthcare facilities participated in the survey, representing both acute care (n=30) and LTC (n=10) facilities in all geographic regions of Maryland. Surveillance cultures were obtained from 92% (358/390) of eligible patients. A. baumannii was identified in 34% of all mechanically ventilated patients in Maryland; multidrug-resistant A. baumannii was found in 27% of all patients. A. baumannii was detected in at least 1 patient in 49% of participating facilities; 100% of LTC facilities had at least 1 patient with A. baumannii, compared with 31% of acute care facilities. A. baumannii was identified from all facilities in which 10 or more patients were sampled. Conclusions: A. baumannii is common among mechanically ventilated patients in both acute care and LTC facilities throughout Maryland, with a high proportion of isolates demonstrating multidrug resistance.