Multidrug Resistance Acinetobacter Bacteremia Secondary to Ventilator-Associated Pneumonia: Risk Factors and Outcome

Evgeni Brotfain, Abraham Borer, Leonid Koyfman, Lisa Saidel-Odes, Amit Frenkel, Shaun E. Gruenbaum, Vsevolod Rosenzweig, Alexander Zlotnik, Moti Klein

Research output: Contribution to journalArticlepeer-review

28 Scopus citations

Abstract

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.

Original languageEnglish
Pages (from-to)528-534
Number of pages7
JournalJournal of Intensive Care Medicine
Volume32
Issue number9
DOIs
StatePublished - 1 Oct 2017

Keywords

  • Acinetobacter baumannii
  • multidrug resistant Acinetobacter VAP
  • multidrug resistant Acinetobacter bacteremia
  • outcome
  • risk factor

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

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