Identifying risk factors for carbapenem-resistant Acinetobacter baumannii carriage upon admission: a case-case control study
Abstract
Active screening programs and early detection of asymptomatic carriers are effective in preventing carbapenem-resistant Acinetobacter baumannii (CRAB) dissemination in healthcare facilities. This study aims to identify risk factors associated with CRAB carriage among patients upon admission to an acute care hospital. A case-case-control study was conducted at an acute care hospital. Starting in June 2020, new admissions to medical wards underwent rectal and buccal screening. Patients with CRAB or carbapenem-susceptible A. baumannii (CSAB) carriage were compared to controls, randomly selected from patients with negative cultures, at a one-to-one ratio. Multinomial logistic regression using a backward stepwise method was employed to identify factors associated with CRAB and CSAB carriage. A Chi-square Automatic Interaction Detector analysis was also conducted to further elucidate risk factors. The study included 115 CRAB carriers, 117 CSAB carriers and 121 controls. Increasing age was associated with a reduced risk of CSAB (OR: 0.96, p < 0.001) and CRAB carriage (OR: 0.97, p = 0.02), while higher Charlson Comorbidity Index scores increased the risk for both. CRAB carriage was significantly associated with admission from long-term acute care hospitals (OR: 7.68, p < 0.001) and presence of pressure ulcers (OR: 89.98, p < 0.001). Decision tree analysis identified pressure ulcers, prior location, and Charlson score as key predictors, with CRAB carriage reaching 77.3% in patients…
How strong is the evidence?
Evidence Hub reads this as a case-control. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause.
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