Prospective study of risk factors for ventilator-associated pneumonia caused by Acinetobacter species

Medina, Julio C.; Formento, Carlos; Pontet, Julio; Curbelo, Andrea; Bazet, Cristina; Gerez, Jorge; Larrañaga, Eduardo

doi:10.1016/j.jcrc.2006.06.010

Cited by 28 publications

(25 citation statements)

References 35 publications

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“…The possibilities, such as community acquisition or health care provider-associated dissemination, remain to be demonstrated. Sputum was a major source of A. baumannii, and the organism was associated with ventilator-associated pneumonia [28] and may indicate respiratory colonization and subsequent invasion [29]. A. baumannii was also isolated in conjunction with other nosocomial pathogens such as methicillin-resistant S. aureus and P. aeruginosa and denotes a dangerous combination of polymicrobial infections, offering more collective resistance.…”

Section: Discussionmentioning

confidence: 99%

Patient Demographics and Characteristics of Infection with Carbapenem-Resistant <i>Acinetobacter baumannii</i> in a Teaching Hospital from the United States

Vaze¹,

Emery²,

Hamilton³

et al. 2013

AID

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A characterization of the clinical demographic features of patients with infection caused Acinetobacter baumannii, and the antibiotyping of the isolates recovered from these patients was undertaken, with a special reference to carbapenemresistant variants, and their risk factors. This study was conducted retrospectively from January 2010 to March 2011 at a 616-bed tertiary care university hospital. Sixty-four patients were identified. Clinical and microbiological data were analyzed for risk factors and demographic features to derive relative risk and odds ratio. We identified 100 A. baumannii from 64 patients during 15 months period. Significant risk factors were working age (18 -60 years), male gender, hospital stay (>1 week but <1 month), prior hospitalization, in a progressive care nursing units, respiratory/mechanical ventilation, polymicrobial infections and prior antibiotic therapy. Methicillin-resistant staphylococcus aureus (MRSA), Pseudomonas aeruginosa, and Klebsiella pneumoniae were the significant co-infecting agents. The antibiogram demonstrated multidrug resistance in a majority of the isolates. Relative risk associated with ventilator, diabetes, and surgery was higher in repeat isolates than in first isolates and were multidrug resistant. Repeat isolates were more resistant that the first isolates to most anti-acinetobacter agents, but the overall crude mortality was not significant during this study period, and couldn't correlated to the choice of treatment. In conclusion, a resistance against all clinically used carbapenems, and colistin is rapidly increasing in repeat isolates of A. baumannii; leaves narrow therapeutic options to treat multidrug-resistant and pandrug-resistant A. baumannii infection. For the first time we report rising incidence of colistin resistance by 20 percent in repeat isolates, and is worrisome for healthcare centers. A combination therapy should be adopted to treat such infection to avoid the emergence of colistin-resistant phenotypes in the United States.

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Section: Discussionmentioning

confidence: 99%

Patient Demographics and Characteristics of Infection with Carbapenem-Resistant <i>Acinetobacter baumannii</i> in a Teaching Hospital from the United States

Vaze¹,

Emery²,

Hamilton³

et al. 2013

AID

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“…pneumonia in English literature. [34] However, all studies were performed in intensive care units (ICUs) on intubated patients. The difference between the present study and the other studies is that the present study not only included all HAPs developed within the entire hospital, but also investigated the patients with HAP, VAP and pneumonia occurring during immunosuppressive treatment.…”

Section: Discussionmentioning

confidence: 99%

Acinetobacter pneumonia: Is the outcome different from the pneumonias caused by other agents

et al. 2010

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BACKGROUND:The principal aim of the present study was to determine whether Acinetobacter spp. pneumonia differs from hospital-acquired pneumonias (HAPs) caused by other agents with respect to therapeutic success and survival rate.METHODS:This study includes 140 adult patients diagnosed with HAPs caused by identified etiologic agents between March 2005 and February 2006. These patients were divided into two groups according to the agent responsible for their infection (Acinetobacter spp. [n = 63] or non-Acinetobacter spp. [n = 77]). The groups were compared in terms of risk factors, therapeutic success and six-week survival rates.RESULTS:Previous antibiotic use and the risk of aspiration were independent factors responsible for the development of Acinetobacter spp. pneumonia. Hypoalbuminemia, steroid use and the use of a mechanical ventilator were determined to be mortality-associated independent risk factors for Acinetobacter spp. pneumonia. The clinical success rate at the end of therapy was 41.6% and, at the sixth week, the survival rate was 35% among patients in whom Acinetobacter spp. was the causative agent. Conversely, in the control group, these values were 43 and 32%, respectively (P > 0.05). We found that the use of the appropriate antibiotics for the treatment of Acinetobacter spp. pneumonia was an important factor in survival (P < 0.001).CONCLUSION:The outcomes of Acinetobacter spp. pneumonia do not differ from HAPs associated with non-Acinetobacter spp. in terms of therapeutic success and survival rates.

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“…As major risk factors were considered to be hospital size (>500 beds), previous antimicrobial therapy, use of a Foley catheter and surgery, the analysis concluded that a key element in infection control should be better differentiation between colonisation and infection in order to limit inappropriate use of antibiotics. After studying 125 mechanically ventilated patients in a surgical ICU, with VAP caused by A. baumannii in 46 patients, in univariate analysis Medina et al [49] found previous use of ceftriaxone and ciprofloxacin as independent risk factors for the development of VAP. The second most commonly arising risk factor in case-control studies was mechanical ventilation, described in 25% of studies [43].…”

Section: Resistance Surveillance and Risk Factorsmentioning

confidence: 99%

Acinetobacter baumannii: a universal threat to public health?

Giamarellou

Antoniadou

Kanellakopoulou

2008

International Journal of Antimicrobial Agents

198

136

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Prospective study of risk factors for ventilator-associated pneumonia caused by Acinetobacter species

Cited by 28 publications

References 35 publications

Patient Demographics and Characteristics of Infection with Carbapenem-Resistant <i>Acinetobacter baumannii</i> in a Teaching Hospital from the United States

Patient Demographics and Characteristics of Infection with Carbapenem-Resistant <i>Acinetobacter baumannii</i> in a Teaching Hospital from the United States

Acinetobacter pneumonia: Is the outcome different from the pneumonias caused by other agents

Acinetobacter baumannii: a universal threat to public health?

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Prospective study of risk factors for ventilator-associated pneumonia caused by Acinetobacter species

Cited by 28 publications

References 35 publications

Patient Demographics and Characteristics of Infection with Carbapenem-Resistant &lt;i&gt;Acinetobacter baumannii&lt;/i&gt; in a Teaching Hospital from the United States

Patient Demographics and Characteristics of Infection with Carbapenem-Resistant &lt;i&gt;Acinetobacter baumannii&lt;/i&gt; in a Teaching Hospital from the United States

Acinetobacter pneumonia: Is the outcome different from the pneumonias caused by other agents

Acinetobacter baumannii: a universal threat to public health?

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Patient Demographics and Characteristics of Infection with Carbapenem-Resistant <i>Acinetobacter baumannii</i> in a Teaching Hospital from the United States

Patient Demographics and Characteristics of Infection with Carbapenem-Resistant <i>Acinetobacter baumannii</i> in a Teaching Hospital from the United States