Risk factors for infection by Acinetobacter baumannii in intubated patients with nosocomial pneumonia.

Abstract

STUDY OBJECTIVE: To investigate the epidemiology of infection by Acinetobacter baumannii in patients with ventilator-associated pneumonia (VAP). DESIGN: Prospective clinical study. SETTING: Three medical-surgical ICUs in teaching hospitals. PATIENTS: We followed up 707 mechanically ventilated patients and 148 episodes of VAP with etiologic diagnosis. RESULTS: A baumannii was isolated in 12 (8.1%) episodes in 148 patients. Five of these episodes were directly responsible for death. Using logistic regression analysis, the risk of VAP due to A baumannii was found to be high in patients with neurosurgery (odds ratio [OR]=10.03; 95% confidence interval [CI]=1.55 to 64.90), ARDS (OR=9.73; 95% CI=1.60 to 59.24), head trauma (OR=5.17; 95% CI=0.88 to 30.34), and large-volume pulmonary aspiration (OR=2.90; 95% CI=0.80 to 10.53). CONCLUSIONS: Intubated patients who develop pneumonia and have any of the above factors are at an increased risk of Acinetobacter infection.