Carbapenem-resistant Acinetobacter baumannii infections in intensive care units: incidence, infection prevention and control, and antimicrobial stewardship practices in the cross-border region between Italy and France, 2019–2022

@article{vicentini2026carbapenemresistant,
  title = {{Carbapenem-resistant Acinetobacter baumannii infections in intensive care units: incidence, infection prevention and control, and antimicrobial stewardship practices in the cross-border region between Italy and France, 2019–2022}},
  author = {C. Vicentini and R. Bussolino and E. Kuczewski and C. Elias and A. Machut and S. Bettoni and M. Perego and L. Bresciano and L. Ramondetti and A. Friggeri and A. Lepape and C.M. Zotti and S. Finazzi and F. Agostini and L. Argaud and N. Barzaghi and Y. Berrouane and J. Bohé and C. Bolla and V. Bonato and E. Brizio and P. Caironi and V. Chartier and J. Crozon-Clauzel and A.D. Selva and S. Debord-Peguet and G. Dessertaine and S. Di Blasi and F. Di Nardo and G. Fiore and M. Gleize and B. Grisi and S. Gatti and V. Gavinelli and H. Hyvernat and C. Landelle and A.-C. Lukaszewicz and A. Maiello and P. Mardrus and A. Mastroianni and B. Mitola and G.G. Montrucchio and E. Munier-Marion and C. Olivieri and O. Ossola and R. Plattier and C. Pommier and T. Rimmelé and J.-C. Richard and M. Salvatico and P. Selvaggi and D. Silengo and P. Silvaplana and C. Silvestre and P.R. Soldà and P. Toscano and C. Vaccari and V. Venturino and E. Vivier and F. Wallet},
  journal = {Journal of Hospital Infection},
  year = {2026},
  month = sep,
  doi = {10.1016/j.jhin.2026.01.019},
  url = {https://hal.science/hal-05752002v1},
  note = {CC BY},
}

TY  - JOUR
TI  - Carbapenem-resistant Acinetobacter baumannii infections in intensive care units: incidence, infection prevention and control, and antimicrobial stewardship practices in the cross-border region between Italy and France, 2019–2022
AU  - C. Vicentini
AU  - R. Bussolino
AU  - E. Kuczewski
AU  - C. Elias
AU  - A. Machut
AU  - S. Bettoni
AU  - M. Perego
AU  - L. Bresciano
AU  - L. Ramondetti
AU  - A. Friggeri
AU  - A. Lepape
AU  - C.M. Zotti
AU  - S. Finazzi
AU  - F. Agostini
AU  - L. Argaud
AU  - N. Barzaghi
AU  - Y. Berrouane
AU  - J. Bohé
AU  - C. Bolla
AU  - V. Bonato
AU  - E. Brizio
AU  - P. Caironi
AU  - V. Chartier
AU  - J. Crozon-Clauzel
AU  - A.D. Selva
AU  - S. Debord-Peguet
AU  - G. Dessertaine
AU  - S. Di Blasi
AU  - F. Di Nardo
AU  - G. Fiore
AU  - M. Gleize
AU  - B. Grisi
AU  - S. Gatti
AU  - V. Gavinelli
AU  - H. Hyvernat
AU  - C. Landelle
AU  - A.-C. Lukaszewicz
AU  - A. Maiello
AU  - P. Mardrus
AU  - A. Mastroianni
AU  - B. Mitola
AU  - G.G. Montrucchio
AU  - E. Munier-Marion
AU  - C. Olivieri
AU  - O. Ossola
AU  - R. Plattier
AU  - C. Pommier
AU  - T. Rimmelé
AU  - J.-C. Richard
AU  - M. Salvatico
AU  - P. Selvaggi
AU  - D. Silengo
AU  - P. Silvaplana
AU  - C. Silvestre
AU  - P.R. Soldà
AU  - P. Toscano
AU  - C. Vaccari
AU  - V. Venturino
AU  - E. Vivier
AU  - F. Wallet
PY  - 2026
DA  - 2026/09/16
JO  - Journal of Hospital Infection
DO  - 10.1016/j.jhin.2026.01.019
UR  - https://hal.science/hal-05752002v1
AB  - BACKGROUND: Carbapenem-resistant Acinetobacter baumannii (CRAB) is a priority-1 critical pathogen with limited treatment options and high mortality among intensive care unit (ICU) patients. Italy reports hyperendemic levels, whereas France maintains low prevalence. Understanding cross-border differences is essential to inform infection prevention and control (IPC) and antibiotic stewardship strategies. AIM: We investigated incidence trends of CRAB infections in ICUs across the French-Italian border and assessed structural, organizational, IPC, and stewardship practices to identify factors associated with infection risk. METHODS: We conducted a multi-centre observational study involving ICUs of four cross-border regions (Piemonte, Valle d'Aosta, Auvergne-Rhône-Alpes, and Provence-Alpes-Côte d'Azur). Data on ICU-acquired bloodstream infections (BSI), central-line-associated BSI, pneumonia, and ventilator-associated pneumonia with CRAB isolates were extracted from the GiViTI and Réa-Rézo surveillance systems (2019-2022). A structured survey explored ICU characteristics, IPC, and stewardship practices. Logistic regression analysis was performed to identify factors associated with CRAB infection episodes. RESULTS: Overall, 25 ICUs participated in data collection. Among 24,822 ICU admissions, the proportion of A. baumannii isolates that were carbapenem resistant was 18.75% (95% confidence interval [CI]: 7.97-34.98) in France and 83.56% (95% CI: 80.1-86.63) in Italy. Different approaches to IPC and antibiotic stewardship were highlighted. Structural ICU design, staffing flexibility, and resilient IPC and stewardship practices were associated with lower infection risk. CONCLUSION: The CRAB incidence was substantially higher in Italy than in France. Cross-border harmonization of surveillance and co-ordinated preventive strategies are critical to contain cross-border spread.
SN  - 0195-6701
SN  - 1532-2939
ER  -