[Clinical features of ventilator-associated pneumonia caused by acinetobacter].
OBJECTIVE
To investigate the clinical features of ventilator-associated pneumonia (VAP) caused by acinetobacter.


METHODS
The clinical manifestations of 45 cases with ventilator-associated pneumonia caused by acinetobacter between 1995 and 2002 were analyzed. Bacterial susceptibility of acinetobacter strains was determined by Kerby-Bauer method.


RESULTS
The mean age of the subjects was 58 +/- 13 years with 31 patients older than 60 years. All the patients had underlying diseases, most of which were respiratory diseases (37.8%), nervous system diseases (22.2%), and trauma (22.2%). Thirteen cases (28.9%) were mixed infections with other bacteria. The main manifestations were fever, purulent secretion, and solidification in the lung. X-ray revealed inflammatory infiltration in lower lobes of both sides. The mortality was 37.8%. The in vitro activity tests of 28 antibiotics against the acinetobacter strains showed that they were multiresistant. Polymysin B, imipenem, minocycline, ofloxacin, and amikacin were relatively active.


CONCLUSIONS
The patients with VAP caused by acinetobacter usually had underlying diseases without unique features and high mortality, and the isolated strains were often mutiresistant. It is necessary to make early diagnosis, select the appropriate agents, and improve the disinfection of the breath loop in the ventilator.
Chen
Ji-quan
JQ
Department of Respiratory Medicine, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China. jqchen67@hotmail.com
Luo
Wen-tong
WT
D000150:Acinetobacter / Q000302:isolation & purification*; D000151:Acinetobacter Infections / Q000382:microbiology; D000368:Aged; D003428:Cross Infection / Q000209:etiology*; D024881:Drug Resistance, Bacterial; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018410:Pneumonia, Bacterial / Q000382:microbiology*; D012122:Ventilators, Mechanical / Q000382:microbiology*