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.