title: Influencing factors of successful eradication of multidrug-resistant Acinetobacter baumannii in the respiratory tract with aerosolized colistin.
abstract: BACKGROUND
  The increased prevalence of multidrug-resistant Acinetobacter baumannii (MDRAB) poses a worldwide treatment challenge. Although aerosolized colistin therapy for MDRAB pneumonia has attracted increasing interest, factors influencing successful eradication remain unclear.
  
  
  METHODS
  This retrospective study evaluated 135 consecutively admitted adult patients showing positive respiratory secretion cultures for MDRAB who underwent aerosolized colistin therapy between January 2007 and November 2011. Possible factors related to pneumonia and MDRAB eradication were collected for analysis.
  
  
  RESULTS
  Patients with successful MDRAB eradication on Day 14 had a shorter interval between the day the positive MDRAB sputum cultures were yielded and the day colistin inhalation treatment began (4.0 ± 2.5 vs. 7.3 ± 6.5; p = 0.002). Patients with a worsening chest X-ray on Day 7 of the colistin inhalation had a lower chance of 14-day MDRAB eradication [1/44 (2.3%) vs. 8/37 (21.6%); p = 0.006]. Patients with diabetes mellitus also had a lower chance of early MDRAB eradication [13/44 (29.5%) vs. 20/37 (54.1%); p = 0.025].
  
  
  CONCLUSIONS
  Early intervention using aerosolized colistin in patients with MDRAB pneumonia or colonization can achieve better eradication.
authors.forename: Yu-Mu
authors.initials: YM
authors.lastname: Chen
authors.forename: Wen-Feng
authors.initials: WF
authors.lastname: Fang
authors.forename: Hsu Ching
authors.initials: HC
authors.lastname: Kao
authors.forename: Hung-Chen
authors.initials: HC
authors.lastname: Chen
authors.forename: Yuh-Chyn
authors.initials: YC
authors.lastname: Tsai
authors.forename: Lien-Shi
authors.initials: LS
authors.lastname: Shen
authors.forename: Chin-Ling
authors.initials: CL
authors.lastname: Li
authors.forename: Huang-Chih
authors.initials: HC
authors.lastname: Chang
authors.forename: Kuo-Tung
authors.initials: KT
authors.lastname: Huang
authors.forename: Meng-Chih
authors.initials: MC
authors.lastname: Lin
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung; Department of Respiratory Care, Chang Gung University of Science and Technology, Chiayi; Department of Respiratory Therapy, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine; Graduate Institute of Occupational Safety and Health, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Chin-Chou
authors.initials: CC
authors.lastname: Wang
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
authors.forename: Tung-Ying
authors.initials: TY
authors.lastname: Chao
mesh_terms: D000151:Acinetobacter Infections / Q000188:drug therapy*; D040981:Acinetobacter baumannii / Q000302:isolation & purification*; D000280:Administration, Inhalation; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D003091:Colistin / Q000627:therapeutic use*; D024901:Drug Resistance, Multiple, Bacterial / Q000187:drug effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011014:Pneumonia; D012137:Respiratory System / Q000187:drug effects; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D003091:Colistin