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Inventi Impact: Advanced Nursing

Articles

  • Inventi:han/29260/19
    Ventilator-Associated Pneumonia Due to Drug- Resistant Acinetobacter baumannii: Risk Factors and\nMortality Relation with Resistance Profiles, and Independent Predictors of In-Hospital Mortality
    Research 2019 : July - September
    Ausra Ciginskiene, Asta Dambrauskiene, Jordi Rello, Dalia Adukauskiene

    Background and objectives: High mortality and healthcare costs area associated with\nventilator-associated pneumonia (VAP) due to Acinetobacter baumannii (A.baumannii). The data\nconcerning the link between multidrug-resistance of A.baumannii strains and outcomes remains\ncontroversial. Therefore, we aimed to identify the relation of risk factors for ventilator -associated\npneumonia (VAP) and mortality with the drug resistance profiles of Acinetobacter baumannii\n(A.baumannii) and independent predictors of in-hospital mortality. Methods: A retrospective ongoing\ncohort study of 60 patients that were treated for VAP due to drug-resistant A.baumannii in medicalsurgical\nintensive care units (ICU) over a two-year period was conducted. Results: The proportions\nof multidrug-resistant (MDR), extensively drug-resistant (XDR), and potentially pandrug-resistant\n(pPDR) A.baumannii were 13.3%, 68.3%, and 18.3%, respectively. The SAPS II scores on ICU\nadmission were 42.6, 48.7, and 49 (p = 0.048); hospital length of stay (LOS) prior to ICU was 0, one,\nand two days (p = 0.036), prior to mechanical ventilation (MV)-0, 0, and three days (p = 0.013), and\ncarbapenem use prior to VAP-50%, 29.3%, and 18.2% (p = 0.036), respectively. The overall inhospital\nmortality rate was 63.3%. In MDR, XDR, and pPDR A.baumannii VAP groups, it was 62.5%,\n61.3%, and 72.7% (p = 0.772), respectively. Binary logistic regression analysis showed that female\ngender (95% OR 5.26; CI: 1.21â??22.83), SOFA score on ICU admission (95% OR 1.28; CI: 1.06â??1.53)\nand RBC transfusion (95% OR 5.98; CI: 1.41â??25.27) were all independent predictors of in-hospital\nmortality. Conclusions: The VAP risk factors: higher SAPS II score, increased hospital LOS prior to\nICU, and MV were related to the higher resistance profile of A.baumannii. Carbapenem use was\nfound to be associated with the risk of MDR A.baumannii VAP. Mortality due to drug-resistant\nA.baumannii VAP was high, but it was not associated with the A.baumannii resistance profile. Female\ngender, SOFA score, and RBC transfusion were found to be independent predictors of in -hospital\nmortality.

    How to Cite this Article
    Attribution/ CC Compliant Citation: Ciginskiene, Ausra, et al. \"Ventilator-Associated Pneumonia due to Drug-Resistant\nAcinetobacter baumannii: Risk Factors and Mortality Relation with Resistance Profiles, and Independent Predictors of\nIn-Hospital Mortality.\" Medicina 55.2 (2019): 49.\nhttps://doi:10.3390/medicina55020049\nhttp://creativecommons.org/licenses/by/4.0/\n\nSome formatting elements, header, footer, logos, dates and pagination were modified while adapting this article.\n\n
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