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- Title
Carbapenem-resistant Acinetobacter ventilator-associated pneumonia: Clinical characteristics and outcome.
- Authors
Gurjar, Mohan; Saigal, Saurabh; Baronia, Arvind Kumar; Rao, Bhaskar P.; Azim, Afzal; Poddar, Banani; Singh, Ratender Kumar
- Abstract
Objective: To study the clinical characteristics and 28-days mortality in patients with ventilator-associated pneumonia (VAP) due to carbapenem-resistant Acinetobacter (CRA). Design: Retrospective, observational, cohort study. Setting: Intensive care unit (ICU) of a university hospital. Materials and Methods: Microbiologically confirmed VAP due to CRA infection. Intervention: None. Results: Out of 87 patients with VAP due to CRA, 60 (69%) were male; whose median age was 51 years; 73 (84%) patients were medical; 26 (30%) had history of hospitalization in last 3 months; median acute physiology and chronic health evaluation (APACHE) II was 15 and median SOFA 9 at admission; primary reason for ICU admission was respiratory failure (34%); 46 (53%) patients had more than 2 organ failure at ICU admission; median length of ICU stay was 19 days; 66 (76%) patients need vasoactive agents during ICU stay, whereas 55 (63%) patients had renal failure; median duration of mechanical ventilation was 17 days; 22 (25%) patients had acute respiratory distress syndrome (ARDS) during ICU stay; 72 (83%) patients had exposure to carbapenem before inclusion in the study; 33 (38%) patients had same organism at other sites. In the follow-up, 47 (54%) patient survived at 28 days after having VAP; whereas only 40 (46%) patients were discharged from the hospital. Conclusions: CRA-VAP has high crude mortality. Advanced age; severity of illness and presence of pneumonia at ICU admission; and presence of shock, ARDS and renal failure have impact on outcome in these patients
- Subjects
INDIA; ANTIBIOTICS; PNEUMONIA-related mortality; ACADEMIC medical centers; AGE distribution; COMBINATION drug therapy; CHI-squared test; STATISTICAL correlation; DRUG resistance; FISHER exact test; INTENSIVE care units; SCIENTIFIC observation; HEALTH outcome assessment; PNEUMONIA; U-statistics; MECHANICAL ventilators; LOGISTIC regression analysis; TREATMENT effectiveness; RETROSPECTIVE studies; SEVERITY of illness index; DATA analysis software; DESCRIPTIVE statistics; THERAPEUTICS; SYMPTOMS
- Publication
Indian Journal of Critical Care Medicine, 2013, Vol 17, Issue 3, p129
- ISSN
0972-5229
- Publication type
Article
- DOI
10.4103/0972-5229.117036