Incidence and outcome of healthcare-associated acinetobacter baumannii in chronically ventilated patients in a tertiary care hospital in Taiwan

Horng Chyuan Lin, Shu Min Lin, Chih Hsi Kuo, Fu Tsai Chung, Chih Teng Yu, Chien Ying Liu, Kang Yun Lee, Yu Lun Lo, Ting Yu Lin, Tsai Yu Wang, Te Chih Hsiung, Han Pin Kuo

Research output: Contribution to journalArticle

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Abstract

Most studies related to healthcare-associated infection with Acinetobacter baumannii (HAIA) are on acutely ventilated patients. Little is known regarding the incidence and outcomes of HAIA in chronically ventilated patients. Methods: A retrospective study of chronically ventilated patients covering the period May 2002 to May 2008 was conducted to determine the incidence of patients with HAIA. The Cox proportional hazard model was used to estimate differences in the 30-day mortality between those with and those without HAIA by case-control study after controlling for confounders. Results: Of 240 patients who were chronically ventilated for 49,207 days, 78 (32.5%) acquired HAIA at a rate of 1.59/1,000 patient day. The central venous catheter-related bloodstream infections rate was 8.78 per 1,000 catheter days; the ventilator-associated pneumonia rate was 1.26 per 1,000 ventilator days; and the catheter-associated urinary tract infections rate was 0.17 per 1,000 catheter days. Fifty (64.1%) HAIA and 58 (64.4%) non-HAIA patients were treated well and survived without ICU admission. After univariate and multivariate analyses, prolonged ventilation days (odds ratio: 3.4; 95% confidence interval: 1.7-6.1; P = 0.01] and inappropriate empiric antibiotics within 48 hours (odds ratio: 7.9; 95% confidence interval: 3.9-9.8; P = 0.02) were independent factors that predicted the 30-day mortality of HAIA among chronically ventilated patients. Conclusions: Although chronically ventilated patients with HAIA have longer ventilator days, higher antibiotics resistance, and high rate per 100 patients of ventilator-associated pneumonia, most patients are treated well. Compared with patients without HAIA, prolonged ventilation days and inappropriate empiric antibiotics within 48 hours are independent factors of the 30-day mortality.

Original languageEnglish
Pages (from-to)361-366
Number of pages6
JournalAmerican Journal of the Medical Sciences
Volume341
Issue number5
DOIs
Publication statusPublished - May 2011
Externally publishedYes

Fingerprint

Acinetobacter baumannii
Tertiary Healthcare
Taiwan
Tertiary Care Centers
Cross Infection
Delivery of Health Care
Incidence
Ventilator-Associated Pneumonia
Catheter-Related Infections
Mechanical Ventilators
Ventilation
Mortality
Catheters
Odds Ratio
Confidence Intervals
Anti-Bacterial Agents
Central Venous Catheters
Microbial Drug Resistance
Proportional Hazards Models
Urinary Tract Infections

Keywords

  • Chronic ventilation
  • Healthcare-associated infection with Acinetobacter baumannii
  • Inappropriate antibiotics treatment
  • Outcome
  • Prolonged ventilation

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Incidence and outcome of healthcare-associated acinetobacter baumannii in chronically ventilated patients in a tertiary care hospital in Taiwan. / Lin, Horng Chyuan; Lin, Shu Min; Kuo, Chih Hsi; Chung, Fu Tsai; Yu, Chih Teng; Liu, Chien Ying; Lee, Kang Yun; Lo, Yu Lun; Lin, Ting Yu; Wang, Tsai Yu; Hsiung, Te Chih; Kuo, Han Pin.

In: American Journal of the Medical Sciences, Vol. 341, No. 5, 05.2011, p. 361-366.

Research output: Contribution to journalArticle

Lin, Horng Chyuan ; Lin, Shu Min ; Kuo, Chih Hsi ; Chung, Fu Tsai ; Yu, Chih Teng ; Liu, Chien Ying ; Lee, Kang Yun ; Lo, Yu Lun ; Lin, Ting Yu ; Wang, Tsai Yu ; Hsiung, Te Chih ; Kuo, Han Pin. / Incidence and outcome of healthcare-associated acinetobacter baumannii in chronically ventilated patients in a tertiary care hospital in Taiwan. In: American Journal of the Medical Sciences. 2011 ; Vol. 341, No. 5. pp. 361-366.
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abstract = "Most studies related to healthcare-associated infection with Acinetobacter baumannii (HAIA) are on acutely ventilated patients. Little is known regarding the incidence and outcomes of HAIA in chronically ventilated patients. Methods: A retrospective study of chronically ventilated patients covering the period May 2002 to May 2008 was conducted to determine the incidence of patients with HAIA. The Cox proportional hazard model was used to estimate differences in the 30-day mortality between those with and those without HAIA by case-control study after controlling for confounders. Results: Of 240 patients who were chronically ventilated for 49,207 days, 78 (32.5{\%}) acquired HAIA at a rate of 1.59/1,000 patient day. The central venous catheter-related bloodstream infections rate was 8.78 per 1,000 catheter days; the ventilator-associated pneumonia rate was 1.26 per 1,000 ventilator days; and the catheter-associated urinary tract infections rate was 0.17 per 1,000 catheter days. Fifty (64.1{\%}) HAIA and 58 (64.4{\%}) non-HAIA patients were treated well and survived without ICU admission. After univariate and multivariate analyses, prolonged ventilation days (odds ratio: 3.4; 95{\%} confidence interval: 1.7-6.1; P = 0.01] and inappropriate empiric antibiotics within 48 hours (odds ratio: 7.9; 95{\%} confidence interval: 3.9-9.8; P = 0.02) were independent factors that predicted the 30-day mortality of HAIA among chronically ventilated patients. Conclusions: Although chronically ventilated patients with HAIA have longer ventilator days, higher antibiotics resistance, and high rate per 100 patients of ventilator-associated pneumonia, most patients are treated well. Compared with patients without HAIA, prolonged ventilation days and inappropriate empiric antibiotics within 48 hours are independent factors of the 30-day mortality.",
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AU - Chung, Fu Tsai

AU - Yu, Chih Teng

AU - Liu, Chien Ying

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KW - Inappropriate antibiotics treatment

KW - Outcome

KW - Prolonged ventilation

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