Acinetobacter baumanniiInfection in Prior ICU Bed Occupants Is an Independent Risk Factor for Subsequent Cases of Ventilator-Associated Pneumonia (original) (raw)
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Bali Medical Journal, 2020
Purpose: Ventilator-associated pneumonia is a significant disease with high mortality rates. Acinetobacter baumannii is one of the most critical pathogens leading to ventilator-associated pneumonia. This study aims to evaluate the underlying risk factors in patients diagnosed with ventilator-associated pneumonia caused by Acinetobacter baumannii, who were followed in intensive care units of our hospital. Patients and Methods: The data of 112 patients diagnosed with ventilator-associated pneumonia caused by Acinetobacter baumannii, who were followed in Intensive Care Units other than Pediatric Intensive Care Unit of our hospital from 2013 to 2017, were evaluated retrospectively. Results: Of the cases included in our study, 70.5% were male, and 29.5% were female patients. Of the cases, 87.5% were followed in Anaesthesiology and Reanimation Intensive Care Unit. The most common modifiable risk factors are mechanical ventilation, antacid use, and the most common non-modifiable risk factors were the presence of trauma and a history of cardiovascular disease. Conclusion: Ventilator-associated pneumonia is a clinical condition with high mortality and morbidity in intensive care units. Incidence and mortality of ventilator-associated pneumonia can be reduced through the implementation of some necessary policies for the prevention of ventilator-associated pneumonia and the practices for the reduction or elimination of modifiable risk factors.
Chest Journal, 1997
Study objective: To investigate the epidemiology of infection by Acinetobacter baumannii in patients with ventilator-associated pneumonia (VAP). Design: Prospective clinical study. Setting: Three medical-surgical ICUs in teaching hospitals. Patients: We followed up 707 mechanically ventilated patients and 148 episodes of VAP with etiologic diagnosis. Results: A baumannii was isolated in 12 (8.1%) episodes in 148 patients. Five of these episodes were directly responsible for death. Using logistic regression analysis, the risk of VAP due to A baumannii was found to be high in patients with neurosurgery (odds ratio [OR] = 10.03; 95% confidence interval [CI] = 1.55 to 64.90), ARDS (OR=9.73; 95% CI=1.60 to 59.24), head trauma (OR=5.17; 95% CI=0.88 to 30.34), and large-volume pulmonary aspiration (OR=2.90; 95% CI=0.80 to 10.53).
Medicina
Background and objectives: High mortality and healthcare costs area associated with ventilator-associated pneumonia (VAP) due to Acinetobacter baumannii (A.baumannii). The data concerning the link between multidrug-resistance of A.baumannii strains and outcomes remains controversial. Therefore, we aimed to identify the relation of risk factors for ventilator-associated pneumonia (VAP) and mortality with the drug resistance profiles of Acinetobacter baumannii (A.baumannii) and independent predictors of in-hospital mortality. Methods: A retrospective ongoing cohort study of 60 patients that were treated for VAP due to drug-resistant A.baumannii in medicalsurgical intensive care units (ICU) over a two-year period was conducted. Results: The proportions of multidrug-resistant (MDR), extensively drug-resistant (XDR), and potentially pandrug-resistant (pPDR) A.baumannii were 13.3%, 68.3%, and 18.3%, respectively. The SAPS II scores on ICU admission were 42.6, 48.7, and 49 (p = 0.048); hospital length of stay (LOS) prior to ICU was 0, one, and two days (p = 0.036), prior to mechanical ventilation (MV)-0, 0, and three days (p = 0.013), and carbapenem use prior to VAP-50%, 29.3%, and 18.2% (p = 0.036), respectively. The overall inhospital mortality rate was 63.3%.
American Journal of Infection Control, 2014
Acinetobacter baumannii is characterized by a rapid development of resistance to the commonly used antimicrobial agents. We investigated the risk factors, clinical features, and outcomes in ventilatorassociated pneumonia (VAP) caused by extensive drug-resistant Acinetobacter baumannii (XDRAB). Clinical parameters and overall in-hospital mortality rates were compared between the VAP with and without XDRAB infection groups. This study showed that VAP caused by XDRAB was not associated with in-hospital mortality. However, it was related to high Simplified Acute Physiology Score II scores and increasing durations of hospital stays.
Ventilator-associated Acinetobacter baumannii pneumonia
Indian Pediatrics, 2011
T he incidence of ventilator-associated pneumonia (VAP) in pediatric patients varies from 5.1%-33.3% [1-3]. Acinetobacter has emerged as a common causative agent of nosocomial infections, particularly VAP [4-6]. Originally thought to be lowgrade pathogen contaminating the hospital environment, with its inherent ability to survive in diverse reservoirs and develop resistance to disinfectants and antimicrobials, it has transformed into an emerging, multidrug-resistant nosocomial pathogen [7]. We report an outbreak, subsequent identification of source and control of VAP caused by carbapenemresistant Acinetobacter baumannii in 6 infants admitted to the pediatric intensive care unit (PICU). METHODS The outbreak occurred between 18th September to 10 th October 2008 at the PICU, which annually admits over 1200 children up to 15 years of age.
Antibiotics
Multidrug-resistant A. baumannii (MDRAB) VAP has high morbidity and mortality, and the rates are constantly increasing globally. Mono- and polybacterial MDRAB VAP might differ, including outcomes. We conducted a single-center, retrospective (January 2014–December 2016) study in the four ICUs (12–18–24 beds each) of a reference Lithuanian university hospital, aiming to compare the clinical features and the 30-day mortality of monobacterial and polybacterial MDRAB VAP episodes. A total of 156 MDRAB VAP episodes were analyzed: 105 (67.5%) were monomicrobial. The 30-day mortality was higher (p < 0.05) in monobacterial episodes: overall (57.1 vs. 37.3%), subgroup with appropriate antibiotic therapy (50.7 vs. 23.5%), and subgroup of XDR A. baumannii (57.3 vs. 36.4%). Monobacterial MDRAB VAP was associated (p < 0.05) with Charlson comorbidity index ≥3 (67.6 vs. 47.1%), respiratory comorbidities (19.0 vs. 5.9%), obesity (27.6 vs. 9.8%), prior hospitalization (58.1 vs. 31.4%), prior an...
Health Sciences, 2020
Background. This analysis is aimed to determine the incidence of risk factors for VAP, drug resistance of A.baumannii strains, 7-day (early) and 28-day (late) mortality, and association of risk factors for VAP with early and late mortality in multidrug-resistant (MDR) A.baumannii VAP patients cohort. Materials and methods. Adult subjects with the first episode of MDR A.baumannii VAP during 2 years period were included. VAP was diagnosed using the 2005 ATS/IDSA criteria. Risk factors for VAP predicting early and late mortality were estimated using binary logistic regression analysis. Results. The incidence of risk factors for VAP among 60 MDR A.baumannii VAP patients was: both continuous sedation and stress ulcer prophylaxis –100%, exposure to intravenous broad-spectrum antibiotics within the last 90 days – 98.3%, current hospitalization ≥ 5 days – 95.0%, red blood cell transfusion – 60.0%, sepsis – 53.3%, mechanical ventilation before VAP >8 days and SAPS II score > 50 on I...