TY - JOUR
T1 - Multidrug Resistance Acinetobacter Bacteremia Secondary to Ventilator-Associated Pneumonia
T2 - Risk Factors and Outcome
AU - Brotfain, Evgeni
AU - Borer, Abraham
AU - Koyfman, Leonid
AU - Saidel-Odes, Lisa
AU - Frenkel, Amit
AU - Gruenbaum, Shaun E.
AU - Rosenzweig, Vsevolod
AU - Zlotnik, Alexander
AU - Klein, Moti
N1 - Publisher Copyright:
© 2017 Author(s).
PY - 2017/10/1
Y1 - 2017/10/1
N2 - 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.
AB - 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.
KW - Acinetobacter baumannii
KW - multidrug resistant Acinetobacter VAP
KW - multidrug resistant Acinetobacter bacteremia
KW - outcome
KW - risk factor
UR - http://www.scopus.com/inward/record.url?scp=85029120086&partnerID=8YFLogxK
U2 - 10.1177/0885066616632193
DO - 10.1177/0885066616632193
M3 - Article
C2 - 26902255
AN - SCOPUS:85029120086
SN - 0885-0666
VL - 32
SP - 528
EP - 534
JO - Journal of Intensive Care Medicine
JF - Journal of Intensive Care Medicine
IS - 9
ER -