Prospective study of risk factors for ventilator-associated pneumonia caused by Acinetobacter species.
The incidence of ventilator-associated pneumonia (VAP) by Acinetobacter spp (VAPA) is increasing and has high morbidity and mortality. It is imperative to identify risk factors to be able to use prevention policies.


OBJECTIVE
The aim of this study was to identify specific risk factors for VAPA.


METHODS
Prospective cohort study.


METHODS
None.


METHODS
Two medical-surgical intensive care units.


METHODS
During a period of 36 months, all patients with more than 48 hours on mechanical ventilation and suspected of having a VAP were enrolled. Only VAP with microbiological confirmation was analyzed.


RESULTS
Two hundred eighteen consecutive patients with clinical suspicion of VAP were enrolled. One hundred twenty-five VAPs were confirmed by culture--46 by Acinetobacter spp and 79 by other pathogens. The 36 potential risk factors for Acinetobacter spp were analyzed by univariate analysis. Logistic regression identified previous use of ceftriaxone (relative risk, 5.1; 95% confidence interval, 1.47-17.82) and previous use of ciprofloxacin (relative risk, 9.1; 95% confidence interval, 2.29-36.63) as significant independent predictors for the development of VAPA.


CONCLUSIONS
Previous use of ceftriaxone and ciprofloxacin are independent risk factors for the development of VAPA.
Medina
Julio
J
Cátedra de Enfermedades Infecciosas, Instituto de Higiene, Facultad de Medicina, Universidad de la República, Montevideo CP 11600, Uruguay. jcmedina@hc.edu.uy
Formento
Carlos
C
Pontet
Julio
J
Curbelo
Andrea
A
Bazet
Cristina
C
Gerez
Jorge
J
Larrañaga
Eduardo
E
D000151:Acinetobacter Infections / Q000453:epidemiology* / Q000401:mortality; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002443:Ceftriaxone / Q000627:therapeutic use; D002939:Ciprofloxacin / Q000627:therapeutic use; D005260:Female; D006801:Humans; D015994:Incidence; D007362:Intensive Care Units; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D053717:Pneumonia, Ventilator-Associated / Q000453:epidemiology* / Q000401:mortality; D011446:Prospective Studies; D012307:Risk Factors
D000900:Anti-Bacterial Agents; D002939:Ciprofloxacin; D002443:Ceftriaxone