Program Schedule

776
Acinetobacter baumannii ventilator acquired pneumonia in a high density unit of North India

Session: Poster Abstract Session: Clinical Respiratory Infections
Friday, October 10, 2014
Room: The Pennsylvania Convention Center: IDExpo Hall BC
Posters
  • dr navneet sharma.pdf (316.1 kB)
  • Background: Acinetobacter baumannii (AB) is responsible for 8-10% cases of late ventilator acquired pneumonia in the ICU. 

    Methods: Prospective study of all AB– VAP cases admitted to the Medical High Density Unit (HDU) from 1st March 2010 to 31st March 2011.

    Results: Of 50 cases, 33 were males and 17 females. Mean age was 42.8± 17.1 years (range=15-88 years). Thirty seven cases were referred to our hospital from a primary health center (mean stay = 5.5±1.2 days). AB-VAP occurred after 11.5± 4.3 days in-hospital. Underlying conditions were; diabetes mellitus in 34%, essential hypertension in 36%, immunosuppressive therapy in 8% and coronary artery disease in 4%. Risk factors for AB-VAP were; neurological disorders in 36%; severe sepsis in 16%; organophosphorous poisoning in 10% and diabetic ketoacidosis and  acute kidney failure in 6% each. The mortality rate was 52%. Antibiotic resistance pattern of AB showed that 82% isolates were multi-drug resistant and 58% carbapenem resistant. Chi square analysis revealed that carbapenem resistance in AB-VAP isolates correlated to mortality. Upon multivariate analysis, survivors (n=24) differed from non-survivors (n=26) in a shorter length of stay at the primary level hospital, a significantly shorter duration of HDU stay and total length of stay at this hospital and lower SOFA score at time of culture positivity. On comparing the time period that invasive catheters were retained in these patients of AB-VAP, shorter retention times of central venous catheters, urinary catheters and endotracheal tubes was observed in survivors. 

    Conclusion: AB-VAP in the medical HDU, has a high mortality rate. Risk factors for mortality are a prolonged period of stay in primary level hospitals, increased retention time of invasive catheters and endotracheal tubes and the presence of carbapenem resistance in the AB isolates

    Navneet Sharma, MD, Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India and Vikas Gautam, MD, Post-graduate institute of medical education & research, Chandigarh, India

    Disclosures:

    N. Sharma, None

    V. Gautam, None

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