Acinetobacter baumannii and Klebsiella pneumoniae Coinfection – A Dual Threat in Healthcare Setting

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Abstract Background: Klebsiella pneumoniae and Acinetobacter baumannii , both members of the ESKAPE (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter species) group of priority pathogens, are frequently implicated in severe multidrug-resistant (MDR) infections, particularly in critical care settings. Coinfections involving these two organisms present an even greater clinical challenge. Materials and Methods: This prospective observational study, conducted over 4 years at a tertiary care center, evaluated the clinical profile, treatment, and outcomes of adult patients with culture-confirmed coinfection by K . pneumoniae and A . baumannii . Results: Twenty-five patients had coinfection, all required ventilatory support, 88% required intensive care unit (ICU) admission, and 72% presented with shock. Carbapenem resistance was seen in all A . baumannii isolates and K . pneumoniae blood isolates. Empirical therapy included polymyxins for all patients. The median ICU stay was 15.5 days, hospital stay 24 days, and cost of care Rs. 555,662. The inhospital mortality rate was 44%. Conclusion: The high rates of resistance, invasive interventions, prolonged hospitalizations, and mortality highlight the severity of these coinfections. Early detection, strict infection control, and tailored antimicrobial strategies are essential to mitigate their impact.

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