title: Acinetobacter baumannii infection in prior ICU bed occupants is an independent risk factor for subsequent cases of ventilator-associated pneumonia.
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.
  
  
  CONCLUSIONS
  ICU admission or the hospitalization of patients infected by Acinetobacter baumannii increases the risk of AbVAP by subsequent patients.
authors.affiliation: Department of Critical Care Medicine, University Hospital of Larisa and School of Medicine, University of Thessaly, Biopolis, 41000 Larisa, Greece.
authors.forename: Eirini
authors.initials: E
authors.lastname: Tsakiridou
authors.affiliation: Department of Critical Care Medicine, University Hospital of Larisa and School of Medicine, University of Thessaly, Biopolis, 41000 Larisa, Greece.
authors.forename: Demosthenes
authors.initials: D
authors.lastname: Makris
authors.affiliation: Department of Respiratory Medicine, University Hospital of Larisa and School of Medicine, University of Thessaly, Biopolis, 41000 Larisa, Greece.
authors.forename: Zoe
authors.initials: Z
authors.lastname: Daniil
authors.affiliation: Department of Critical Care Medicine, University Hospital of Larisa and School of Medicine, University of Thessaly, Biopolis, 41000 Larisa, Greece.
authors.forename: Efstratios
authors.initials: E
authors.lastname: Manoulakas
authors.affiliation: Department of Critical Care Medicine, General Hospital of Serres, 62100 Serres, Greece.
authors.forename: Vasiliki
authors.initials: V
authors.lastname: Chatzipantazi
authors.affiliation: Department of Critical Care Medicine, General Hospital of Serres, 62100 Serres, Greece.
authors.forename: Odysseas
authors.initials: O
authors.lastname: Vlachos
authors.affiliation: Department of Critical Care Medicine, General Hospital of Serres, 62100 Serres, Greece.
authors.forename: Grigorios
authors.initials: G
authors.lastname: Xidopoulos
authors.affiliation: Department of Critical Care Medicine, General Hospital of Serres, 62100 Serres, Greece.
authors.forename: Olympia
authors.initials: O
authors.lastname: Charalampidou
authors.affiliation: Department of Critical Care Medicine, University Hospital of Larisa and School of Medicine, University of Thessaly, Biopolis, 41000 Larisa, Greece.
authors.forename: Epaminondas
authors.initials: E
authors.lastname: Zakynthinos
mesh_terms: D040981:Acinetobacter baumannii / Q000302:isolation & purification / Q000472:pathogenicity*; D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D007239:Infections / Q000209:etiology / Q000382:microbiology / Q000503:physiopathology*; D007362:Intensive Care Units; D008875:Middle Aged; D053717:Pneumonia, Ventilator-Associated / Q000209:etiology / Q000382:microbiology / Q000503:physiopathology*; D012307:Risk Factors
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