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2014, Number 2

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Acta Med 2014; 12 (2)

Ventilator associated pneumonia by multi-drug resistant (MDR Acinetobacter baumannii) in a third level intensive care unit

Rojo EA, Rivera BC

Language: Spanish
References: 20
Page: 57-64
PDF size: 220.03 Kb.


ABSTRACT

Objective: To determine the epidemiology of ventilator-associated pneumonia (VAP) by multidrug-resistant Acinetobacter baumannii (MDRAb), as well as susceptibility patterns and antimicrobial resistance. Methods: Observational, descriptive, transversal, retrospective study of patients with MDRAb VAP in Hospital General de México Intensive Care Unit. Results: There were 42 cases of VAP by MDRAb, corresponding to 1,584 days-ventilator, with a rate of 26.5 episodes/1,000 days-ventilator. There were 27 deaths (64.3%), related to the acquisition of MDRAb VAP. All patients had previously received a broad spectrum antimicrobial (mean 7 days) and required intubation and mechanical ventilation during their stay in intensive care (mean 12.33 days [± 6]). The antimicrobial susceptibilities were mainly to carbapenem with MIC ‹ 4 µg/mL and for β-lactam β-lactamase inhibitor with MIC ‹ 8/4 µg/mL. Conclusions: A high incidence rate of MDRAb VAP was found. The main risk factor for VAP was the need for and prolonged invasive mechanical ventilation. Mortality was favored by MDRAb infection as an independent variable and the key prognostic factor was the initial empiric therapy used.


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