Clinical characteristics and treatment outcomes of <i>Acinetobacter baumannii</i> bloodstream infections in a setting with high carbapenem susceptibility among isolates

In our setting, carbapenem-susceptible <i>Acinetobacter baumannii</i> (CSAB, <i>n</i> = 56/71, 78.9%) bloodstream infections (BSIs) were far more common than with carbapenem-resistant isolates (CRAB). CRAB BSI was associated with intensive care onset, prior carbapenem use, and had higher mortality (73.3% versus 16.1%). In CSAB BSI, after adjusting for elevated C-reactive protein, the definitive use of carbapenems for treatment remained independently associated with adverse outcomes (adjusted odds ratio 7.34, 95%CI 1.25-43.01). These findings may suggest that carbapenem-sparing regimens may be effective alternative antibiotic choices for CSAB. Although treatment guidelines focus on CRAB, future prospective studies should also evaluate optimal treatment strategies for CSAB.