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 ICU admis­sion – 50.0%. The resistance of A.baumannii strains to both piperacillin/tazobactam and ciprofloxacin was 100%, to carbapenems, cephalosporins 95.0%, to colistin 0%. Early mortality it was estimated to be 28.3%, late one – 55.0%. The SOFA score >12 on ICU admission have predicted early (OR 7.5; 95% CI 2.052-27.408, p=0.002) and late (OR 4.089; 95% Cl 1.292-12.92, p=0.017) mortality, >3 classes of antibiotics used before the onset of VAP (OR 3.993; 95% CI 1.050-15.193, p=0.042) – late one. Conclusions. It was estimated twice higher late versus early mortality, and marginal resistance of A.baumannii strains to piperacillin/tazobactam, car­bapenems, cephalosporins and ciprofloxacin but co­listin. Both early and late mortality was predicted by higher severity of illness by SOFA score on ICU admission, but only late one – by the treatment with > 3 different classes of antibiotics before VAP onset.

No abstract