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CLINICAL INVESTIGATIONS

Clinical impact of pneumonia caused byAcinetobacter baumannii in intubated patients: A matched cohort study*

Garnacho, Jose MD; Sole-Violan, Jordi MD; Sa-Borges, Marcio MD; Diaz, Emili MD; Rello, Jordi MD, PhD

Author Information

From Hospital Universitario Virgen del Rocio (JG), Sevilla, Spain; Hospital Dr Negrin (JS-V), Las Palmas de Gran Canaria, Spain; Hospital de Son Llàtzer (MS-B), Palma de Mallorca, Spain; and Hospital Universitari Joan XXIII (ED, JR), Tarragona, Spain.

*See also p. 2557.

Supported, in part, by grants from CIRIT SGR2001/414 and Red Respira.

In intubated patients, pneumonia byAcinetobacter baumannii is not significantly associated with attributable mortality rate or an increase length of intensive care unit stay.

Critical Care Medicine31(10):p 2478-2482, October 2003. |DOI:10.1097/01.CCM.0000089936.09573.F3

Abstract

Objective 

To determine whether ventilator-associated pneumonia caused byAcinetobacter baumannii (VAPAB) is associated with increased mortality rate.

Design 

A retrospective matched case-control study in which all intensive care unit adult patients with microbiologically documented VAPAB were defined as cases.

Setting 

Four intensive care units from teaching hospitals.

Patients 

Sixty patients were matched to sixty controls.

Measurements and Main Results 

Controls were matched based on stay before pneumonia onset, disease severity (Acute Physiology and Chronic Health Evaluation II) at admission, and diagnostic category. Population characteristics and intensive care unit mortality rates of patients with VAPAB and their controls were compared. Attributable mortality was determined by subtracting the crude mortality rate of the controls from the crude mortality rate of the case patients. Twenty-four of the 60 case patients died, representing a crude mortality rate of 40%, whereas 17 of the 60 controls died, a crude mortality rate of 28.3% (p = .17). Crude intensive care unit mortality was the same (12 of 35, 34.2%) in patients with VAPAB caused by strains sensitive to imipenem and in their matched controls. It was 44% for the 25 patients with imipenem-resistant strains with an estimated attributable mortality rate of 20.0% (95% confidence interval, −5.6% to 45.7%). Mean intensive care unit stay of patients and controls was 35.3 and 36.6 days, respectively (p = nonsignificant).

Conclusion 

In intubated patients, pneumonia byA. baumannii is not significantly associated with attributable mortality rate or an increased length of intensive care unit stay.

Copyright © by 2003 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved.

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