Abstract
Ventilator-associated pneumonia (VAP) has been considered as a healthcare-associated infection with high mortality. Acinetobacter baumannii and Klebsiella pneumoniae are the common causes of VAPs around the world. This research was a retrospective observational study in the intensive care unit (ICU) in a tertiary referral collegiate hospital in Tehran between March 2016 and May 2018. Patients who fulfilled VAP due to documented Multidrug Resistant Acinetobacter baumannii (MDR-AB) or Extended Spectrum Beta Lactamase-producing Klebsiella pneumoniae (ESBL-KP) criteria were enrolled. General demographic features, duration of hospital stay, antimicrobial treatment regimens, duration of ICU admission, the period of mechanical ventilation (MV) and 30-day mortality were documented and compared. 210 patients were found with clinical, microbiological and radiological evidence of VAP. In total, 76 patients with MDR-AB and 76 patients with ESBL-KP infections were matched in the final analysis. Duration of hospitalization in the patients with MDR-AB was significantly more than that of patients infected with ESBL-KP (p-value: 0.045). Patients diagnosed with MDR-AB VAP had a 65.8% mortality rate compared to 42.1% in the ESBL-KP infection group (p = 0.003). Results of the present study demonstrated that VAPs caused by MDR-AB may be more hazardous than ESBL-KP VAPs because they could be accompanied by a longer hospitalization course and even a higher mortality.
Highlights
Ventilator-associated pneumonia (VAP) has been considered as a healthcare-associated infection with high mortality
All clinical data of the patients who were under mechanical ventilation in intensive care unit (ICU) from March 2016 to May 2018 were systematically analysed and the patients who fulfilled the following criteria were enrolled in the study: 1) age >18 years; 2) Patients admitted in ICU; 3) Their radiologic studies showed newly formed consolidation or other signs of parenchymal involvement; 4) VAPs due to documented Multidrug Resistant Acinetobacter baumannii (MDR-Acinetobacter baumannii (AB)) or Extended Spectrum Beta Lactamase-producing Klebsiella pneumoniae (ESBL-Klebsiella pneumoniae (KP))
The most common causes of healthcareassociated pneumonias (HAPs) and VAPs were Pseudomonas aeruginosa, Acinetobacter species, and methicillin-resistant Staphylococcus aureus, but recent studies have shown an increase in the prevalence of Klebsiella pneumoniae and Acinetobacter species [11,17,18,19]
Summary
In a survey conducted between 2010 and 2014 in the United States, the most common lower respiratory system infection was communityacquired pneumonia (CAP) (54.3%) and ventilatorassociated pneumonia (VAP) had the lowest prevalence (1.6%), but the mortality rate related to CAP was 7.9% while for VAP it was about three folds (21.6%) higher [2]. Pseudomonas aeruginosa and methicillin-resistant Staphylococcus aureus remain among common etiologic agents of VAP, Acinetobacter baumannii (AB) and Klebsiella pneumoniae (KP) are known as the most important causes of VAP in many ICUs all around the world [410]. In spite of increasing our knowledge about the causes and agents of VAP and even its prevention, this lower respiratory infection is still a serious complication of ICU admitted patients and the need to Salehi et al – Pneumonia: Acinetobacter vs Klebsiella. No studies have compared patients who develop VAPs regarding these two agents. We analysed differences with regards to the duration of hospital and ICU stay as well as the days on mechanical ventilation
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
