293 Challenges and Outcomes of Tuberculosis Exposure Investigations Among Healthcare Workers in a Safety-Net Hospital
Abstract
Introduction: Acinetobacter infections are commonly viewed as hospital-onset events linked to critical illness and invasive devices. We evaluated whether this paradigm holds true at our institution by examining a decade of Acinetobacter infections at an urban safety-net trauma center. Methods: We conducted a retrospective analysis of patients with Acinetobacter spp. isolated from culture at a 500-bed urban academic safety-net Level I trauma center from January 2015 through December 2025. Clinical and epidemiologic variables were abstracted from the electronic health record. Hospital-onset infection was defined as culture collection on or after hospital day 4 (admission day = day 1). Infections not meeting criteria for hospital onset were classified as community-onset and subsequently assessed for healthcare-associated exposures. Healthcare-associated infection was defined by hospitalization, antibiotic exposure, dialysis, or residence in a skilled nursing facility within 60 days prior to diagnosis. Additional covariates included age, sex, birth place, race/ethnicity, intensive care unit (ICU) admission, active chemotherapy or chronic steroid use, chronic lung disease (e.g., chronic obstructive pulmonary disease or COPD), chronic liver disease (cirrhosis or hepatitis B/C), diabetes, substance use disorder (alcohol or illicit drugs), trauma within 90 days, presence of an invasive airway (endotracheal tube or tracheostomy), indwelling urinary or renal catheters, organism…
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Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence.
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