Study: 4% of US collegiate athletes developed long COVID – University of Minnesota Twin Cities

A study of hospitalized Veterans Affairs (VA) patients found that combination therapy was not associated with decreased mortality for multidrug-resistant (MDR) Acinetobacter infections, researchers reported yesterday in Antimicrobial Stewardship & Healthcare Epidemiology.

The retrospective cohort study, led by a team of VA researchers, looked at VA patients who were hospitalized with MDR Acinetobacter bacteremia and received antibiotics 2 days prior through 5 days after the culture date from 2012 through 2018. The aim was to assess the impact of antibiotic treatments on in-hospital, 30-day, and 1-year mortality and costs.

MDRAcinetobacter spp.was identified in 184 patients. Most patients were older (mean age, 67 years), White, non-Hispanic men. The vast majority of cultures identified wereA baumannii (90%), while 3% wereA lwoffii,and 7% were otherAcinetobacter species.Half (50.5%) of the infected patients died in hospital, 44% within 30 days, and 67.9% within 1 year.

Penicillins/beta-lactamase inhibitor combinations (51.1%) and carbapenems (51.6%) were the most prescribed antibiotics. In unadjusted analysis, extended-spectrum cephalosporins and penicillins/beta-lactamase inhibitor combinations were associated with a decreased odds of 30-day mortality, but the effect was insignificant after adjustment (adjusted odds ratio (aOR), 0.47; 95% confidence interval [CI], 0.21 to 1.05 and aOR, 0.75; 95% CI, 0.37 to 1.53, respectively). There was no association between combination therapy vs monotherapy and 30-day mortality (aOR, 1.55; 95% CI, 0.72 to 3.32).

The results are noteworthy, the authors say, because while the Sanford Guide and the Infectious Diseases Society of America recommend combination therapy (high-dose ampicillin-sulbactam plus an additional agent) for treating severe MDRAcinetobacterinfections, the findings add to evidence from prior studies that have found limited improved clinical outcomes with combination therapy.

"Our results provide additional comparative effectiveness demonstrating a lack of benefit to combination therapy given within 2 through +5 days from the culture date," they wrote.

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Study: 4% of US collegiate athletes developed long COVID - University of Minnesota Twin Cities