Perception of the hospitalization process among survivors of carbapenem-resistant Acinetobacter baumannii bacteremia: A qualitative study

Abstract

Background

Survivors of carbapenem-resistant Acinetobacter baumannii (CRAB) bacteremia endure complex hospitalizations; their perspectives remain underexplored.

Methods

We conducted a qualitative study at a tertiary hospital. Survivors (≥18 years) of CRAB bloodstream infection from 2019 to 2024, discharged ≥6 months, were invited to narrative video-call interviews. Interviews were analyzed using critical discourse analysis (CDA) to examine meanings around hospitalization, health care communication, and understanding of resistant bacteria.

Results

Nine participants were interviewed. Narratives revealed: (1) hospitalization process and aftermath---profound emotional distress, physical limitations, and long-lasting consequences, with comparisons of life “before” and “after”; (2) barriers in patient-professional communication---limited or absent explanations about procedures, invasive devices, or the infection itself, leading to feelings of alienation and lack of autonomy; and (3) understanding of antibiotic-resistant bacteria---none could define multi-drug resistance, several were unaware of their CRAB diagnosis. Even patients with high health literacy (eg, HIV, aspergillosis, or CMV) did not recall adequate information about antibiotic resistance, underscoring systemic communication gaps.

Discussion

Encouraging patient involvement in infection prevention (eg, reminding staff about hand-hygiene) is promising but underused. Participants sometimes feared adverse reactions when speaking up.

Conclusion

Structured healthcare-associated infections (HAIs) education with patient participation in hand-hygiene reminders is a feasible, patient-centered approach that may improve understanding and shared safety. Implementation could use scripted bedside prompts and brief teach-back, supported by plain-language leaflets and bedside posters co-designed with patients.