Journal of Critical Care
Volume 22, Issue 1 , Pages 18-26, March 2007

Prospective study of risk factors for ventilator-associated pneumonia caused by Acinetobacter species

  • Julio Medina, MD

      Affiliations

    • Cátedra de Enfermedades Infecciosas, Instituto de Higiene, Facultad de Medicina, Universidad de la República, Montevideo CP 11600, Uruguay
    • Corresponding Author InformationCorresponding author. Tel.: +598 2 4876981; fax: +598 2 4876981.
    • ,
  • Carlos Formento, MD

      Affiliations

    • Unidad Cuidados Intensivos del Hospital Pasteur, Montevideo, Uruguay
    • ,
  • Julio Pontet, MD

      Affiliations

    • Unidad Cuidados Intensivos del Hospital Pasteur, Montevideo, Uruguay
    • Physiology Department, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay
    • ,
  • Andrea Curbelo, MD

      Affiliations

    • Unidad Cuidados Intensivos del Hospital Policial, Montevideo, Uruguay
    • ,
  • Cristina Bazet, MD

      Affiliations

    • Laboratorio Clínico, Departamento de Microbiología, Hospital de Clínicas, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay
    • Laboratorio de Microbiología, Hospital Pasteur, Montevideo, Uruguay
    • ,
  • Jorge Gerez, MD

      Affiliations

    • Unidad Cuidados Intensivos del Hospital Policial, Montevideo, Uruguay
    • ,
  • Eduardo Larrañaga, MD

      Affiliations

    • Unidad Cuidados Intensivos del Hospital Policial, Montevideo, Uruguay

published online 03 February 2007.

Abstract 

Summary

The incidence of ventilator-associated pneumonia (VAP) by Acinetobacter spp (VAPA) is increasing and has high morbidity and mortality. It is imperative to identify risk factors to be able to use prevention policies.

Objective

The aim of this study was to identify specific risk factors for VAPA.

Design

Prospective cohort study.

Interventions

None.

Setting

Two medical-surgical intensive care units.

Measurements

During a period of 36 months, all patients with more than 48 hours on mechanical ventilation and suspected of having a VAP were enrolled. Only VAP with microbiological confirmation was analyzed.

Results

Two hundred eighteen consecutive patients with clinical suspicion of VAP were enrolled. One hundred twenty-five VAPs were confirmed by culture—46 by Acinetobacter spp and 79 by other pathogens.

The 36 potential risk factors for Acinetobacter spp were analyzed by univariate analysis.

Logistic regression identified previous use of ceftriaxone (relative risk, 5.1; 95% confidence interval, 1.47-17.82) and previous use of ciprofloxacin (relative risk, 9.1; 95% confidence interval, 2.29-36.63) as significant independent predictors for the development of VAPA.

Conclusions

Previous use of ceftriaxone and ciprofloxacin are independent risk factors for the development of VAPA.

Keywords: Ventilator-associated pneumonia, Acinetobacter spp, Intensive care unit, Antibiotics, Specific risk factors, Prospective cohort study

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PII: S0883-9441(06)00119-5

doi:10.1016/j.jcrc.2006.06.010

Journal of Critical Care
Volume 22, Issue 1 , Pages 18-26, March 2007

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