Risk factors for infection by Acinetobacter baumannii in intubated patients with nosocomial pneumonia.
OBJECTIVE
To investigate the epidemiology of infection by Acinetobacter baumannii in patients with ventilator-associated pneumonia (VAP).


METHODS
Prospective clinical study.


METHODS
Three medical-surgical ICUs in teaching hospitals.


METHODS
We followed up 707 mechanically ventilated patients and 148 episodes of VAP with etiologic diagnosis.


RESULTS
A baumannii was isolated in 12 (8.1%) episodes in 148 patients. Five of these episodes were directly responsible for death. Using logistic regression analysis, the risk of VAP due to A baumannii was found to be high in patients with neurosurgery (odds ratio [OR]=10.03; 95% confidence interval [CI]=1.55 to 64.90), ARDS (OR=9.73; 95% CI=1.60 to 59.24), head trauma (OR=5.17; 95% CI=0.88 to 30.34), and large-volume pulmonary aspiration (OR=2.90; 95% CI=0.80 to 10.53).


CONCLUSIONS
Intubated patients who develop pneumonia and have any of the above factors are at an increased risk of Acinetobacter infection.
Baraibar
J
J
Pulmonary and Critical Care Department, Hospital Italiano, Montevideo, Uruguay.
Correa
H
H
Mariscal
D
D
Gallego
M
M
Vallés
J
J
Rello
J
J
D000150:Acinetobacter / Q000145:classification / Q000302:isolation & purification; D000151:Acinetobacter Infections / Q000209:etiology*; D000328:Adult; D000368:Aged; D001921:Brain / Q000601:surgery; D002423:Cause of Death; D016001:Confidence Intervals; D006259:Craniocerebral Trauma / Q000150:complications; D003428:Cross Infection / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007442:Intubation, Intratracheal / Q000009:adverse effects*; D016015:Logistic Models; D008168:Lung; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D018410:Pneumonia, Bacterial / Q000209:etiology*; D011446:Prospective Studies; D012121:Respiration, Artificial / Q000009:adverse effects; D012128:Respiratory Distress Syndrome / Q000150:complications; D012307:Risk Factors; D013183:Sputum; D013396:Suction; D012122:Ventilators, Mechanical / Q000009:adverse effects*