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Multidrug Resistance Acinetobacter Bacteremia Secondary to Ventilator-Associated Pneumonia: Risk Factors and Outcome
- Source :
- Journal of Intensive Care Medicine. 32:528-534
- Publication Year :
- 2016
- Publisher :
- SAGE Publications, 2016.
-
Abstract
- Purpose: Acinetobacter baumannii is a multidrug resistant (MDR), gram-negative bacterium commonly implicated in ventilator-associated pneumonia (VAP) in critically ill patients. Patients in the intensive care unit (ICU) with VAP often subsequently develop A baumannii bacteremia, which may significantly worsen outcomes. Materials and Methods: In this study, we retrospectively reviewed the clinical and laboratory records of 129 ICU patients spanning 6 years with MDR A baumannii VAP; 46 (35%) of these patients had concomitant MDR A baumannii bacteremia. Results: The ICU mortality rate was higher in patients with VAP having A baumannii bacteremia compared to nonbacteremic patients (32.4% vs 9.6% respectively, P < .005). Age >65 years, an Acute Physiology and Chronic Health Evaluation II (APACHE-II) score higher than 20, a Sequential Organ Failure Assessment (SOFA) score higher than 7 on the day of bacteremia, and the presence of comorbid disease (chronic obstructive pulmonary disease [COPD] and chronic renal failure) were found to be independent risk factors for in-hospital mortality in this population. Multidrug resistant A baumannii was not an independent risk factor for mortality. Conclusion: Although the presence of comorbid diseases (COPD and chronic renal failure) and severity of disease (APACHE > 20 and SOFA >7) were found to be independent risk factors for ICU mortality, MDR A baumannii bacteremia was not an independent risk factor for mortality in our critically ill population.
- Subjects :
- Acinetobacter baumannii
Adult
Male
medicine.medical_specialty
Organ Dysfunction Scores
Critical Illness
Bacteremia
Critical Care and Intensive Care Medicine
03 medical and health sciences
0302 clinical medicine
Risk Factors
Drug Resistance, Multiple, Bacterial
medicine
Humans
Hospital Mortality
030212 general & internal medicine
Risk factor
Intensive care medicine
APACHE
Aged
Retrospective Studies
biology
business.industry
Ventilator-associated pneumonia
Pneumonia, Ventilator-Associated
030208 emergency & critical care medicine
Retrospective cohort study
Middle Aged
Acinetobacter
bacterial infections and mycoses
medicine.disease
biology.organism_classification
Multiple drug resistance
Intensive Care Units
Pneumonia
Female
business
Acinetobacter Infections
Subjects
Details
- ISSN :
- 15251489 and 08850666
- Volume :
- 32
- Database :
- OpenAIRE
- Journal :
- Journal of Intensive Care Medicine
- Accession number :
- edsair.doi.dedup.....658e7ba1c69946c485497b37e6b3aaf1