Risk factors and outcome of Acinetobacter baumanii infection in severe trauma patients

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• 作者：Anselmo Caricato (1)
  Luca Montini (1)
  Giuseppe Bello (1)
  Vincenzo Michetti (1)
  Riccardo Maviglia (1)
  Maria G. Bocci (1)
  Giovanna Mercurio (1)
  Salvatore M. Maggiore (1)
  Massimo Antonelli (1)
  
• 关键词：Acinetobacter baumanii ; Trauma ; Multi ; drug resistant ; Outcome ; Risk factors
• 刊名：Intensive Care Medicine
• 出版年：2009
• 出版时间：November 2009
• 年：2009
• 卷：35
• 期：11
• 页码：1964-1969
• 全文大小：234KB
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• 作者单位：Anselmo Caricato (1)
  Luca Montini (1)
  Giuseppe Bello (1)
  Vincenzo Michetti (1)
  Riccardo Maviglia (1)
  Maria G. Bocci (1)
  Giovanna Mercurio (1)
  Salvatore M. Maggiore (1)
  Massimo Antonelli (1)
  
  1. Istituto Anestesiologia e Rianimazione, Policlinico Universitario A. Gemelli, Università Cattolica del Sacro Cuore, Largo A. Gemelli, 8, 00168, Rome, Italy
  

文摘

Objective To investigate incidence, risk factors and outcome of Acinetobacter baumanii infection in trauma patients. Design and setting A retrospective analysis of prospectively collected data of all trauma patients admitted to a general intensive care unit (ICU) of a 1,500-bed university hospital over 3?years. Patients Three hundred thirty trauma patients were included in the study. Results Thirty-six (10.9%) cases of A. baumanii infection were observed; 29 of them were late onset pneumonia. Patients with A. baumanii infection had a significantly higher Injury Severity Score (ISS) (p?=?0.02), a lower Glasgow Coma Scale (GCS) on ICU admission (p?=?0.03), stayed longer in the ICU (p?=?0.00001), were mechanically ventilated for a longer period of time (p?=?0.00001), were more frequently admitted to the emergency department with hypotension (p?=?0.02), and had trans-skeletal traction for more than 3?days (p?=?0.003) in comparison to the 294 patients who did not develop A. baumanii infection. At multivariate analysis the time spent on mechanical ventilation (p?=?0.02) and the presence of long-term trans-skeletal traction (p?=?0.04) were the only independent risk factors for A. baumanii infection. Patients with A. baumanii infection had a high mortality rate (9 out of 36; 25.0%). ISS (p?=?0.003), GCS (p?=?0.001) and older age (p?=?0.00001), but not A. baumanii infection (p?=?0.15), were independently correlated with mortality. Conclusions In trauma patients prolonged mechanical ventilation and delayed fracture fixation with the persistence of trans-skeletal traction were major risk factors for A. baumanii infection. The presence of this infection was not correlated with mortality.