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(Chest. 1997;112:1050-1054.)
© 1997 American College of Chest Physicians

Risk Factors for Infection by Acinetobacter baumannii in Intubated Patients With Nosocomial Pneumonia

Jorge Baraibar MD1; Humberto Correa MD2; Dolors Mariscal MD3; Miguel Gallego MD3; Jordi Vallés MD, PhD3; and Jordi Rello MD, PhD3

1 From the Pulmonary and Critical Care, and Microbiology Departments, Hospital Italiano, Montevideo, Uruguay
2 From The Hospital de Clinicas, Montevideo, Uruguay
3 From the Hospital de Sabadell, Barcelona, Spain

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.

Key Words: Acinetobacter baumannii • risk factors • ventilator-associated pneumonia

Submitted on August 26, 1996
Accepted on March 12, 1997




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