Acinetobacter baumannii ventilator-associated pneumonia: epidemiology, clinical characteristics, and prognosis factors

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• 作者：Anis Chaari ; Basma Mnif ; Mabrouk Bahloul ; Fouzia Mahjoubi ; Kamilia Chtara ; Olfa Turki ; Nourhene Gharbi ; Hedi Chelly ; Adnene Hammami ; Mounir Bouaziz
• 关键词：Acinetobacter baumannii ; Ventilator-associated pneumonia ; Epidemiology ; Prognosis
• 刊名：International Journal of Infectious Diseases
• 出版年：December, 2013
• 年：2013
• 卷：17
• 期：12
• 页码：e1225-e1228
• 全文大小：403 K

文摘

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Summary

Objective

The aim of this study was to describe the epidemiological characteristics of Acinetobacter baumannii ventilator-associated pneumonia (VAP) and to identify factors predictive of a poor outcome.

Methods

A retrospective study was conducted over 16 months in a Tunisian intensive care unit (ICU). All adult patients with A. baumannii VAP were included.

Results

Ninety-two patients were included in they study; 41 (44.6%) were admitted because of multiple trauma. The mean age of the patients was 44.5 卤 19.5 years. All patients needed mechanical ventilation on admission. The mean SAPS II score was 39 卤 15. The mean delay before VAP onset was 8.1 卤 4.7 days. On VAP onset, 57 patients (62%) developed septic shock. Only 14.2% of isolated strains were susceptible to imipenem; none were resistant to colistin. The mean duration of mechanical ventilation was 20 卤 11 days. The mean duration of ICU stay was 24.3 卤 18.7 days. ICU mortality was 60.9%. In the multivariate analysis, factors predictive of a poor outcome were previously known hypertension (odds ratio 5.8, 95% confidence interval 1.4-24.9; p = 0.018) and VAP-related septic shock (odds ratio 8.5, 95% confidence interval 3-23.7; p < 0.001).

Conclusion

A. baumannii VAP is associated with a high mortality. Hemodynamic impairment is predictive of a poor outcome.