title: Trauma is associated with a better prognosis in intensive care patients with Acinetobacter infections.
abstract: OBJECTIVE
  Acinetobacter baumannii has emerged as a common cause of infection in war-related trauma, civilian trauma and other surgical emergencies. The aim of this study was to determine prognostic factors especially trauma, in critically ill surgical patients with Acinetobacter spp. infection in a reference emergency ICU.
  
  
  METHODS
  A retrospective review of medical records was conducted for all patients admitted to the ICU who developed Acinetobacter spp. infection from January 2007 to December 2009. Bivariate and multivariate analyses were made for 36 patients. The end-point analyzed was the in-hospital mortality.
  
  
  RESULTS
  The initial analysis revealed a majority of young (43.6 years ± 17.1) men (92 %), trauma victims (78 %) and an in-hospital mortality of 30 %. Patients who had not suffered trauma presented with other surgical conditions and were on average older than trauma patients (57 ± 12 versus 40 ± 16 years). The overall APACHE II score average was 15.3. The ventilator-associated pneumonia was the main Acinetobacter infection diagnosed. In bivariate analysis lower Glasgow coma scale (p = 0.01) was associated with increased chance of death and being victim of trauma was a protecting factor (OR: 0.16; 95 % CI: 0.03-0.89). Receiving adequate treatment made no difference to outcome (OR: 0.55; 95 % CI: 0.05-3.15). Multivariate analysis showed that only the presence of trauma was independently associated with prognosis and was a protecting factor.
  
  
  CONCLUSIONS
  Trauma was a marker of good prognosis in emergency ICU patients with Acinetobacter spp. infection.
authors.affiliation: Department of Infectious Diseases and LIM 54, University of São Paulo, Rua Banibas, 618, São Paulo, SP, 05460-010, Brazil.
authors.forename: A C
authors.initials: AC
authors.lastname: Tonacio
authors.forename: M S
authors.initials: MS
authors.lastname: Oliveira
authors.forename: L M S
authors.initials: LM
authors.lastname: Malbouisson
authors.forename: A S
authors.initials: AS
authors.lastname: Levin
mesh_terms: D000151:Acinetobacter Infections / Q000188:drug therapy* / Q000401:mortality; D000328:Adult; D000368:Aged; D003422:Critical Care / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D016896:Treatment Outcome; D014947:Wounds and Injuries / Q000150:complications* / Q000401:mortality; D055815:Young Adult