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Acinetobacter etiology respiratory tract infections associated with mechanical ventilation: what impacts on the prognosis? A retrospective cohort study
- Source :
- Journal of Critical Care. 49:124-128
- Publication Year :
- 2019
- Publisher :
- Elsevier BV, 2019.
-
Abstract
- Introduction Acinetobacter species treatment often represents a challenge. The main objective of this study is identify predictors of ICU mortality in patients submitted to mechanical ventilation (MV). Materials and methods Retrospective cohort study. Patients with MV > 48 h who developed a respiratory tract positive culture for Acinetobacter were included, and distinguished among colonized, ventilator-associated pneumonia (VAP) or ventilator-associated tracheobronchitis (VAT) patients. Primary outcome was ICU mortality. Results 153 patients were in MV and presented positive culture for Acinetobacter calcoaceticus-baumanii complex, 70 of them with VAP, 59 with VAT and 24 patients were colonized. The factors related to ICU mortality were VAP (OR 2.2, 95% CI 1.1–4.5) and shock at the time of diagnosis (OR 4.8, 95% CI 1.8–2.3). In multivariate analysis, only SOFA score at the time of diagnosis (OR 1.06, 95% CI 1.03–1.09) was related with ICU mortality. A paired-matched analysis was performed to assess effect of dual therapy on outcomes, and no effect was found in terms of clinical cure, ICU or hospital mortality or duration of antimicrobial therapy. Conclusions Previous comorbidities and degree of associated organic injury seem to be more important factors in the prognosis than double antibiotic therapy in patients with Acinetobacter-related respiratory infection.
- Subjects :
- Mechanical ventilation
medicine.medical_specialty
Respiratory tract infections
business.industry
medicine.medical_treatment
Ventilator-associated pneumonia
Respiratory infection
030208 emergency & critical care medicine
Retrospective cohort study
Critical Care and Intensive Care Medicine
medicine.disease
Intensive care unit
law.invention
03 medical and health sciences
Pneumonia
0302 clinical medicine
030228 respiratory system
law
Internal medicine
medicine
SOFA score
business
Subjects
Details
- ISSN :
- 08839441
- Volume :
- 49
- Database :
- OpenAIRE
- Journal :
- Journal of Critical Care
- Accession number :
- edsair.doi...........787f524b6740de488dfd514465f7984d