Factors Associated with Outcomes of Acinetobacter baumannii Infection in Ventilator-Associated Pneumonia in the ICU of Dr. Moewardi General Hospital, Surakarta
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Introduction: Acinetobacterbaumannii is a nosocomial pathogen with high mortality rates in intensive care units (ICUs) and is commonly associated with ventilator-associated pneumonia (VAP). Due to declines in physiological and immune functions, A. baumannii can trigger septic shock complications, thereby increasing mortality risk. This study aimed to identify the risk factors associated with outcomes in VAP patients in the ICU of Dr. Moewardi General Hospital, Surakarta.
Methods: This retrospective cohort study was conducted at Dr. Moewardi General Hospital, Surakarta, using patient medical records. Data were analyzed with Chi-square and Mann-Whitney U tests, followed by multiple logistic and linear regression to determine correlations between risk factors and outcomes (recovery, mortality, length of stay/LOS).
Results: This study included 80 patients with VAP caused by A. baumannii. Most patients were under 60 years old (52.5%), had good nutritional status (75%), were on ventilators for less than 10 days (63.75%), and had mild comorbidities (51.25%). Moderate-severe comorbidities (p=0.001) and malnutrition (p=0.005) were significantly associated with increased mortality. In addition, ventilator use ≥10 days was significantly associated with LOS (p<0.001).
Conclusion: Moderate-severe comorbidities and malnutrition were risk factors for mortality in patients with A. baumannii-related VAP, while ventilator use ≥10 days was a risk factor for prolonged hospitalization. Identifying these factors can help medical personnel manage conditions that worsen VAP outcomes and reduce the risk of A. baumannii-related mortality.
Ibrahim S, Al-Saryi N, Al-Kadmy IMS, et al. Multidrug-Resistant Acinetobacter baumannii as an Emerging Concern in Hospitals. Mol Biol Rep 2021; 48: 6987–6998. [PubMed]
Khazaal SS, Al-Saryi N, Ibrahim SA. Immunomodulation by Acinetobacter baumannii of Endotracheal Tube Biofilm in Ventilator-Associated Pneumonia. Meta Gene 2020; 24: 100672. [ScienceDirect]
Xiao T, Guo Q, Zhou Y, et al. Comparative Respiratory Tract Microbiome between Carbapenem-Resistant Acinetobacter baumannii Colonization and Ventilator Associated Pneumonia. Front Microbiol 2022; 13: 782210. [PubMed]
Rosenthal VD, Yin R, Nercelles P, et al. International Nosocomial Infection Control Consortium (INICC) Report of Health Care Associated Infections, Data Summary of 45 Countries for 2015 to 2020, Adult and Pediatric Units, Device-Associated Module. Am J Infect Control 2024; 52: 1002–1011. [PubMed]
Dou H, Hu F, Wang W, et al. Assessment of the Sedative Effects of Dexmedetomidine and Propofol Treatment in Patients undergoing Mechanical Ventilation in the ICU and Relationship between Treatment and Occurrence of Ventilator-Associated Pneumonia and Detection of Pathogenic Bacteria. Exp Ther Med 2020; 20: 599–606. [PubMed]
Wu D, Wu C, Zhang S, et al. Risk Factors of Ventilator-Associated Pneumonia in Critically III Patients. Front Pharmacol 2019; 10: 482. [PubMed]
Duszynska W, Idziak M, Smardz K, et al. Frequency, Etiology, Mortality, Cost, and Prevention of Respiratory Tract Infections-Prospective, One Center Study. J Clin Med; 11. Epub ahead of print June 2022. [PubMed]
Montrucchio G, Corcione S, Lupia T, et al. The Burden of Carbapenem-Resistant Acinetobacter baumannii in ICU COVID-19 Patients: A Regional Experience. J Clin Med; 11. Epub ahead of print September 2022. [PubMed]
Kao HH, Peng CK, Sheu CC, et al. Mortality and Ventilator Dependence in Critically Ill Patients with Ventilator-Associated Pneumonia Caused by Carbapenem-Resistant Acinetobacter baumannii. J Microbiol Immunol Infect 2023; 56: 822–832. [PubMed]
Aligui AAAF, Abad CLR. Multidrug-Resistant VAP Before and During the COVID-19 Pandemic among Hospitalized Patients in a Tertiary Private Hospital. Antimicrob Steward Healthc Epidemiol ASHE 2023; 3: e192. [PubMed]
Kharel S, Bist A, Mishra SK. Ventilator-Associated Pneumonia among ICU Patients in WHO Southeast Asian Region: A Systematic Review. PLoS One 2021; 16: e0247832. [PubMed]
Adukauskiene D, Ciginskiene A, Adukauskaite A, et al. Clinical Features and Outcomes of Monobacterial and Polybacterial Episodes of Ventilator-Associated Pneumonia due to Multidrug-Resistant Acinetobacter baumannii. Antibiot (Basel, Switzerland); 11. Epub ahead of print July 2022. [PubMed]
Motowski H, Ilges D, Hampton N, et al. Determinants of Mortality for Ventilated Hospital-Acquired Pneumonia and Ventilator-Associated Pneumonia. Crit Care Explor 2023; 5: e0867. [PubMed]
Hernandez-Garcia M, Girona-Alarcon M, Bobillo-Perez S, et al. Ventilator-Associated Pneumonia is Linked to a Worse Prognosis than Community-Acquired Pneumonia in Children. PLoS One 2022; 17: e0271450. [PubMed]
Aditya R, Al-Haq MM. Mortality Risk Factors and the Ventilator-Associated Pneumonia (VAP) in the ICU of a Tertiary Hospital in Indonesia. Anaesthesia, Pain Intensive Care 2024; 28: 206–213. [Journal]
Mazwi S, van Blydenstein SA, Mukansi M. Ventilator-Associated Pneumonia in an Academic Intensive Care Unit in Johannesburg, South Africa. African J Thorac Crit Care Med; 29. Epub ahead of print 2023. [PubMed]
Wang S, Zhao X, Wang Q, et al. Impact of Early Enteral Nutrition on Ventilator Associated Pneumonia in Intubated Severe Trauma Patients: A Propensity Score-Matched Study. Front Nutr 2023; 10: 1172526. [PubMed]
Fujiwara A, Minakuchi H, Uehara J, et al. Loss of Oral Self-Care Ability Results in a Higher Risk of Pneumonia in Older Inpatients: A Prospective Cohort Study in a Japanese Rural Hospital. Gerodontology 2019; 36: 236–243. [PubMed]
Natarajan R, Ramanathan V, Sistla S. Poor Sensorium at the Time of Intubation Predicts Polymicrobial Ventilator Associated Pneumonia. Ther Clin Risk Manag 2022; 18: 125–133. [PubMed]
Tetiker S, Türktan M, Esquinas AM. Predictors of Survival after Prolonged Weaning from Mechanical Ventilation. Journal of Critical Care 2021; 63: 269. [PubMed]
Pape ML, Besnard C, Acatrinei C, et al. Clinical Impact of Ventilator-Associated Pneumonia in Patients with the Acute Respiratory Distress Syndrome: A Retrospective Cohort Study. Ann Intensive Care 2022; 12: 24. [PubMed]
Kalil AC, Cawcutt KA. Is Ventilator-Associated Pneumonia More Frequent in Patients with Coronavirus Disease 2019? Critical Care Medicine 2022; 50: 522–524. [PubMed]
Semet C. The Ongoing Challenge of Ventilator-Associated Pneumonia: Epidemiology, Prevention, and Risk Factors for Mortality in a Secondary Care Hospital Intensive Care Unit. Infect Prev Pract 2023; 5: 100320. [PubMed]
Kajeekul R, Thamlikitkul V, Wonglaksanapimon S, et al. Epidemiology of Ventilator-Associated Tracheobronchitis and Ventilator-Associated Pneumonia Caused by Multidrug-Resistant Gram-Negative Bacteria at a Tertiary Care Hospital in Thailand. JAC-Antimicrobial Resist 2024; 6: dlad140. [PubMed]
Liu BM, Hill HR. Role of Host Immune and Inflammatory Responses in COVID-19 Cases with Underlying Primary Immunodeficiency: A Review. J Interferon Cytokine Res 2020; 40: 549–554. [PubMed]
Steen J, Vansteelandt S, Bus LD, et al. Attributable Mortality of Ventilator-Associated Pneumonia. Replicating Findings, Revisiting Methods. Ann Am Thorac Soc 2021; 18: 830–837. [PubMed]
Ma JG, Zhu B, Jiang L, et al. Gender- and Age-Based Differences in Outcomes of Mechanically Ventilated ICU Patients: A Chinese Multicentre Retrospective Study. BMC Anesthesiol 2022; 22: 18. [PubMed]
Shi J, Mao X, Cheng J, et al. Risk Factors and Predictive Model for Nosocomial Infections by Extensively Drug-Resistant Acinetobacter baumannii. Front Cell Infect Microbiol 2024; 14: 1475428. [PubMed]
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