Acinetobacter baumannii infection in prior ICU bed occupants is an independent risk factor for subsequent cases of ventilator-associated pneumonia

Biomed Res Int. 2014:2014:193516. doi: 10.1155/2014/193516. Epub 2014 Jul 2.

Abstract

Objective: We aimed to evaluate risk factors for ventilator-associated pneumonia (VAP) due to Acinetobacter baumannii (AbVAP) in critically ill patients.

Methods: This was a prospective observational study conducted in an intensive care unit (ICU) of a district hospital (6 beds). Consecutive patients were eligible for enrolment if they required mechanical ventilation for >48 hours and hospitalization for >72 hours. Clinical, microbiological, and laboratory parameters were assessed as risk factors for AbVAP by univariate and multivariate analysis.

Results: 193 patients were included in the study. Overall, VAP incidence was 23.8% and AbVAP, 11.4%. Previous hospitalization of another patient with Acinetobacter baumannii infection was the only independent risk factor for AbVAP (OR (95% CI) 12.016 (2.282-19.521) P < 0.001). ICU stay (25 ± 17 versus 12 ± 9 P < 0.001), the incidence of other infections (OR (95% CI) 9.485 (1.640-10.466) P = 0.002) (urinary tract infection, catheter related infection, and bacteremia), or sepsis (OR (95% CI) 10.400 (3.749-10.466) P < 0.001) were significantly increased in patients with AbVAP compared to patients without VAP; no difference was found with respect to ICU mortality.

Conclusion: ICU admission or the hospitalization of patients infected by Acinetobacter baumannii increases the risk of AbVAP by subsequent patients.

MeSH terms

  • Acinetobacter baumannii / isolation & purification
  • Acinetobacter baumannii / pathogenicity*
  • Aged
  • Aged, 80 and over
  • Humans
  • Infections / etiology
  • Infections / microbiology
  • Infections / physiopathology*
  • Intensive Care Units
  • Middle Aged
  • Pneumonia, Ventilator-Associated / etiology
  • Pneumonia, Ventilator-Associated / microbiology
  • Pneumonia, Ventilator-Associated / physiopathology*
  • Risk Factors