title: Multidrug Resistance Acinetobacter Bacteremia Secondary to Ventilator-Associated Pneumonia: Risk Factors and Outcome.
abstract: OBJECTIVE
  Acinetobacter baumannii is a multidrug resistant (MDR), gram-negative bacterium commonly implicated in ventilator-associated pneumonia (VAP) in critically ill patients. Patients in the intensive care unit (ICU) with VAP often subsequently develop A baumannii bacteremia, which may significantly worsen outcomes.
  
  
  METHODS
  In this study, we retrospectively reviewed the clinical and laboratory records of 129 ICU patients spanning 6 years with MDR A baumannii VAP; 46 (35%) of these patients had concomitant MDR A baumannii bacteremia.
  
  
  RESULTS
  The ICU mortality rate was higher in patients with VAP having A baumannii bacteremia compared to nonbacteremic patients (32.4% vs 9.6% respectively, P < .005). Age >65 years, an Acute Physiology and Chronic Health Evaluation II (APACHE-II) score higher than 20, a Sequential Organ Failure Assessment (SOFA) score higher than 7 on the day of bacteremia, and the presence of comorbid disease (chronic obstructive pulmonary disease [COPD] and chronic renal failure) were found to be independent risk factors for in-hospital mortality in this population. Multidrug resistant A baumannii was not an independent risk factor for mortality.
  
  
  CONCLUSIONS
  Although the presence of comorbid diseases (COPD and chronic renal failure) and severity of disease (APACHE > 20 and SOFA >7) were found to be independent risk factors for ICU mortality, MDR A baumannii bacteremia was not an independent risk factor for mortality in our critically ill population.
authors.affiliation: 1 Department of Anesthesiology and Critical Care, General Intensive Care Unit, Soroka Medical Center, Ben-Gurion University of the Negev, Beer Sheva, Israel.
authors.forename: Evgeni
authors.initials: E
authors.lastname: Brotfain
authors.affiliation: 2 Department of Infectious Disease, Soroka Medical Center, Ben-Gurion University of the Negev, Beer Sheva, Israel.
authors.forename: Abraham
authors.initials: A
authors.lastname: Borer
authors.affiliation: 1 Department of Anesthesiology and Critical Care, General Intensive Care Unit, Soroka Medical Center, Ben-Gurion University of the Negev, Beer Sheva, Israel.
authors.forename: Leonid
authors.initials: L
authors.lastname: Koyfman
authors.affiliation: 2 Department of Infectious Disease, Soroka Medical Center, Ben-Gurion University of the Negev, Beer Sheva, Israel.
authors.forename: Lisa
authors.initials: L
authors.lastname: Saidel-Odes
authors.affiliation: 1 Department of Anesthesiology and Critical Care, General Intensive Care Unit, Soroka Medical Center, Ben-Gurion University of the Negev, Beer Sheva, Israel.
authors.forename: Amit
authors.initials: A
authors.lastname: Frenkel
authors.affiliation: 3 Department of Anesthesiology, Yale University School of Medicine, New Haven, CT, USA.
authors.forename: Shaun E
authors.initials: SE
authors.lastname: Gruenbaum
authors.affiliation: 1 Department of Anesthesiology and Critical Care, General Intensive Care Unit, Soroka Medical Center, Ben-Gurion University of the Negev, Beer Sheva, Israel.
authors.forename: Vsevolod
authors.initials: V
authors.lastname: Rosenzweig
authors.affiliation: 1 Department of Anesthesiology and Critical Care, General Intensive Care Unit, Soroka Medical Center, Ben-Gurion University of the Negev, Beer Sheva, Israel.
authors.forename: Alexander
authors.initials: A
authors.lastname: Zlotnik
authors.affiliation: 1 Department of Anesthesiology and Critical Care, General Intensive Care Unit, Soroka Medical Center, Ben-Gurion University of the Negev, Beer Sheva, Israel.
authors.forename: Moti
authors.initials: M
authors.lastname: Klein
mesh_terms: D018806:APACHE; D000151:Acinetobacter Infections / Q000382:microbiology / Q000401:mortality*; D040981:Acinetobacter baumannii; D000328:Adult; D000368:Aged; D016470:Bacteremia / Q000382:microbiology / Q000401:mortality*; D016638:Critical Illness / Q000401:mortality; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D063305:Organ Dysfunction Scores; D053717:Pneumonia, Ventilator-Associated / Q000382:microbiology / Q000401:mortality*; D012189:Retrospective Studies; D012307:Risk Factors
keywords: Acinetobacter baumannii; multidrug resistant Acinetobacter VAP; multidrug resistant Acinetobacter bacteremia; outcome; risk factor