Lunes, 20 Mayo 2019 15:17

Polyclonal endemicity of Acinetobacter baumannii in ventilated patients in an intensive care unit in Uruguay.

Escrito por 

 

 Revista Internacional 

Medina-Presentado JCSeija VVignoli RPontet JRobino LCordeiro NFBado IGarcía-Fulgueiras VBerro MBazet CSavio ERieppi GPolyclonal endemicity of Acinetobacter baumannii in ventilated patients in an intensive care unit in Uruguay. Int J Infect Dis. 2013 Jun;17(6):e422-7.

 

OBJECTIVES: To identify the mechanisms responsible for respiratory infections by Acinetobacter baumannii in intubated patients and risk factors for digestive colonization and infection by A. baumannii.

METHODS: We conducted a prospective study in an intensive care unit (ICU) between May 2005 and November 2006, including 175 consecutive patients at the beginning of invasive ventilation (day 1). We performed pharyngeal and rectal swabs on days 1, 4, 7, 10, 13, and 16. Respiratory samples were taken on days 1 and 7, or on suspicion of ventilator-associated pneumonia (VAP).

RESULTS: We detected 62 patients with A. baumannii digestive colonization and 20 cases of A. baumannii lower respiratory infection (14 VAP and six purulent tracheobronchitis (PTB)). Digestive colonization by A. baumannii was an independent risk factor for lower respiratory tract infections with that microorganism (p<0.0001; relative risk 8.71, 95% confidence interval 2.73-27.77). Respiratory and rectal A. baumannii isolates from the same patients were compared by enterobacterial repetitive intergenic consensus (ERIC)-PCR; in 9/11 cases (eight VAP and one PTB) results suggested events of exogenous pneumonia with previous colonization, whereas the remaining two cases (two PTB) were suggestive of exogenous infection without previous colonization.

CONCLUSIONS: In our unit the pathogenesis of VAP by A. baumannii is mixed, most cases corresponding to exogenous pneumonia with previous colonization.

Leído 241 veces Modificado por última vez en Jueves, 06 Junio 2019 11:21
Inicia sesión para enviar comentarios