Impact of inappropriate antimicrobial therapy on outcome in patients with hospital-acquired pneumonia caused by Acinetobacter baumannii

被引：40

作者：

Joung, Mi Kyong ^{[1
]}

Kwon, Ki Tae ^{[2
]}

Kang, Cheol-In ^{[1
]}

Cheong, Hae Suk ^{[3
]}

Rhee, Ji-Young ^{[4
]}

Jung, Dong Sik ^{[5
]}

Chung, Seung Min ^{[1
]}

Lee, Jeong A. ^{[1
]}

Moon, Soo-Youn ^{[1
]}

Ko, Kwan Soo ^{[7
]}

Chung, Doo Ryeon ^{[1
]}

Lee, Nam Yong ^{[6
]}

Song, Jae-Hoon ^{[1
,7
]}

Peck, Kyong Ran ^{[1
]}

机构：

[1] Sungkyunkwan Univ, Sch Med, Samsung Med Ctr, Div Infect Dis, Seoul, South Korea

[2] Daegue Fatima Hosp, Div Infect Dis, Seoul, South Korea

[3] Konkuk Univ Hosp, Div Infect Dis, Seoul, South Korea

[4] Dankuk Univ Hosp, Div Infect Dis, Seoul, South Korea

[5] Dong A Univ Hosp, Div Infect Dis, Seoul, South Korea

[6] Sungkyunkwan Univ, Sch Med, Samsung Med Ctr, Dept Lab Med, Seoul, South Korea

[7] Asian Pacific Res Fdn Infect Dis ARFID, Seoul, South Korea

来源：

JOURNAL OF INFECTION | 2010年 / 61卷 / 03期

关键词：

Acinetobacter baumannii; Hospital-acquired pneumonia; Inappropriate; Definitive antimicrobial therapy; VENTILATOR-ASSOCIATED PNEUMONIA; PROTECTED SPECIMEN BRUSH; CRITICALLY-ILL PATIENTS; NOSOCOMIAL PNEUMONIA; QUANTITATIVE CULTURE; MORTALITY; BACTEREMIA; RISK; INFECTIONS; RESISTANCE;

D O I：

10.1016/j.jinf.2010.06.014

中图分类号：

R51 [传染病];

学科分类号：

100401 ;

摘要：

Objectives: The purpose of this study was to evaluate the impact of inappropriate antimicrobial therapy on the outcome of patients with hospital-acquired pneumonia (HAP) caused by Acinetobacter baumannii. Methods: All cases of HAP caused by A. baumannii from January 2000 to March 2006 at the Samsung Medical Center (Seoul, Korea) were analyzed retrospectively. Results: A total of 116 patients with clinically significant Acinetobacter HAP were enrolled. Among the A. baumannii isolates, 60.3% showed multi-drug resistance (MDR), 16.4% were found to have imipenem resistance, and 15.5% had pan-drug resistance (PDR). The mean APACHE II score of the patients was 22.3 +/- 7.9. The overall in-hospital and pneumonia-related mortality rates were 47.4% and 37.9%, respectively. The univariate analysis showed that the factors associated with pneumonia-related mortality were: MDR, PDR, high APACHE II score, inappropriate empirical antimicrobial therapy, and inappropriate definitive antimicrobial treatment (All p < 0.05). Among these, a high APACHE II score and inappropriate definitive antimicrobial therapy were found to be independent factors associated with a high mortality, after adjustment for other variables. Conclusions: The appropriate definitive antimicrobial therapy should be provided in patients with HAP caused by A. baumannii. (C) 2010 The British Infection Society. Published by Elsevier Ltd. All rights reserved.

引用

页码：212 / 218

页数：7

共 23 条

[1] Impact of Acinetobacter infection on the mortality of burn patients [J].