Risk factors and outcomes of carbapenem-resistant Acinetobacter baumannii ventilator-associated pneumonia in the neonate: A case-case-control study
Abstract Background Carbapenem-resistant and susceptible Acinetobacter baumannii (CRAB and CSAB) have emerged as serious threats among critically ill neonates. We aimed to identify the risks and outcomes for CRAB and CSAB ventilator-associated pneumonia (VAP) compared with a control group. Methods W...
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Published in | Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy Vol. 22; no. 7; pp. 444 - 449 |
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Main Authors | , , , , , , |
Format | Journal Article |
Language | English |
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Elsevier Ltd
01.07.2016
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Abstract | Abstract Background Carbapenem-resistant and susceptible Acinetobacter baumannii (CRAB and CSAB) have emerged as serious threats among critically ill neonates. We aimed to identify the risks and outcomes for CRAB and CSAB ventilator-associated pneumonia (VAP) compared with a control group. Methods We performed a retrospective and case-case-control study in a neonatal intensive care unit between 2009 and 2014. Results The numbers of patients in the CRAB VAP, CSAB VAP, and control groups were 63, 13, and 25, respectively. The mean gestational ages and median birthweights of CRAB VAP, CSAB VAP, and control groups were 33.2, 35.0, and 32.6 weeks and 1800, 2230, and 2245 g, respectively. By multivariate analysis, infants who had a birthweight of 1000–1499 g ( P = 0.04), cesarean section ( P = 0.01), history of cephalosporin use ( P = 0.02), and surfactant replacement ( P = 0.01) in CRAB VAP were significantly higher than in the control group. Inborn infant ( P = 0.01), reintubation ( P = 0.04), and umbilical artery catheterization ( P = 0.04) in the CRAB VAP group were significantly more than in the CSAB VAP group. The crude mortality rates (CMRs) of CRAB VAP and CSAB VAP were 15.9% and 7.7%, respectively. By univariate analysis, the CMR, septic shock, and bronchopulmonary dysplasia in CRAB VAP were higher than in the control group. Conclusions There are very high mortality and short-term morbidity rates in CRAB VAP. Surfactant replacement therapy, fewer cesarean sections, and the reduced use of cephalosporin in very preterm infants may reduce CRAB VAP. |
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AbstractList | Background: Carbapenem-resistant and susceptible Acinetobacter baumannii (CRAB and CSAB) have emerged as serious threats among critically ill neonates. We aimed to identify the risks and outcomes for CRAB and CSAB ventilator-associated pneumonia (VAP) compared with a control group. Methods: We performed a retrospective and case-case-control study in a neonatal intensive care unit between 2009 and 2014. Results: The numbers of patients in the CRAB VAP, CSAB VAP, and control groups were 63, 13, and 25, respectively. The mean gestational ages and median birthweights of CRAB VAP, CSAB VAP, and control groups were 33.2, 35.0, and 32.6 weeks and 1800, 2230, and 2245 g, respectively. By multivariate analysis, infants who had a birthweight of 1000-1499 g (P = 0.04), cesarean section (P = 0.01), history of cephalosporin use (P = 0.02), and surfactant replacement (P = 0.01) in CRAB VAP were significantly higher than in the control group. Inborn infant (P = 0.01), reintubation (P = 0.04), and umbilical artery catheterization (P = 0.04) in the CRAB VAP group were significantly more than in the CSAB VAP group. The crude mortality rates (CMRs) of CRAB VAP and CSAB VAP were 15.9% and 7.7%, respectively. By univariate analysis, the CMR, septic shock, and bronchopulmonary dysplasia in CRAB VAP were higher than in the control group. Conclusions: There are very high mortality and short-term morbidity rates in CRAB VAP. Surfactant replacement therapy, fewer cesarean sections, and the reduced use of cephalosporin in very preterm infants may reduce CRAB VAP. Carbapenem-resistant and susceptible Acinetobacter baumannii (CRAB and CSAB) have emerged as serious threats among critically ill neonates. We aimed to identify the risks and outcomes for CRAB and CSAB ventilator-associated pneumonia (VAP) compared with a control group. We performed a retrospective and case-case-control study in a neonatal intensive care unit between 2009 and 2014. The numbers of patients in the CRAB VAP, CSAB VAP, and control groups were 63, 13, and 25, respectively. The mean gestational ages and median birthweights of CRAB VAP, CSAB VAP, and control groups were 33.2, 35.0, and 32.6 weeks and 1800, 2230, and 2245 g, respectively. By multivariate analysis, infants who had a birthweight of 1000–1499 g (P = 0.04), cesarean section (P = 0.01), history of cephalosporin use (P = 0.02), and surfactant replacement (P = 0.01) in CRAB VAP were significantly higher than in the control group. Inborn infant (P = 0.01), reintubation (P = 0.04), and umbilical artery catheterization (P = 0.04) in the CRAB VAP group were significantly more than in the CSAB VAP group. The crude mortality rates (CMRs) of CRAB VAP and CSAB VAP were 15.9% and 7.7%, respectively. By univariate analysis, the CMR, septic shock, and bronchopulmonary dysplasia in CRAB VAP were higher than in the control group. There are very high mortality and short-term morbidity rates in CRAB VAP. Surfactant replacement therapy, fewer cesarean sections, and the reduced use of cephalosporin in very preterm infants may reduce CRAB VAP. BACKGROUNDCarbapenem-resistant and susceptible Acinetobacter baumannii (CRAB and CSAB) have emerged as serious threats among critically ill neonates. We aimed to identify the risks and outcomes for CRAB and CSAB ventilator-associated pneumonia (VAP) compared with a control group.METHODSWe performed a retrospective and case-case-control study in a neonatal intensive care unit between 2009 and 2014.RESULTSThe numbers of patients in the CRAB VAP, CSAB VAP, and control groups were 63, 13, and 25, respectively. The mean gestational ages and median birthweights of CRAB VAP, CSAB VAP, and control groups were 33.2, 35.0, and 32.6 weeks and 1800, 2230, and 2245 g, respectively. By multivariate analysis, infants who had a birthweight of 1000-1499 g (P = 0.04), cesarean section (P = 0.01), history of cephalosporin use (P = 0.02), and surfactant replacement (P = 0.01) in CRAB VAP were significantly higher than in the control group. Inborn infant (P = 0.01), reintubation (P = 0.04), and umbilical artery catheterization (P = 0.04) in the CRAB VAP group were significantly more than in the CSAB VAP group. The crude mortality rates (CMRs) of CRAB VAP and CSAB VAP were 15.9% and 7.7%, respectively. By univariate analysis, the CMR, septic shock, and bronchopulmonary dysplasia in CRAB VAP were higher than in the control group.CONCLUSIONSThere are very high mortality and short-term morbidity rates in CRAB VAP. Surfactant replacement therapy, fewer cesarean sections, and the reduced use of cephalosporin in very preterm infants may reduce CRAB VAP. Abstract Background Carbapenem-resistant and susceptible Acinetobacter baumannii (CRAB and CSAB) have emerged as serious threats among critically ill neonates. We aimed to identify the risks and outcomes for CRAB and CSAB ventilator-associated pneumonia (VAP) compared with a control group. Methods We performed a retrospective and case-case-control study in a neonatal intensive care unit between 2009 and 2014. Results The numbers of patients in the CRAB VAP, CSAB VAP, and control groups were 63, 13, and 25, respectively. The mean gestational ages and median birthweights of CRAB VAP, CSAB VAP, and control groups were 33.2, 35.0, and 32.6 weeks and 1800, 2230, and 2245 g, respectively. By multivariate analysis, infants who had a birthweight of 1000–1499 g ( P = 0.04), cesarean section ( P = 0.01), history of cephalosporin use ( P = 0.02), and surfactant replacement ( P = 0.01) in CRAB VAP were significantly higher than in the control group. Inborn infant ( P = 0.01), reintubation ( P = 0.04), and umbilical artery catheterization ( P = 0.04) in the CRAB VAP group were significantly more than in the CSAB VAP group. The crude mortality rates (CMRs) of CRAB VAP and CSAB VAP were 15.9% and 7.7%, respectively. By univariate analysis, the CMR, septic shock, and bronchopulmonary dysplasia in CRAB VAP were higher than in the control group. Conclusions There are very high mortality and short-term morbidity rates in CRAB VAP. Surfactant replacement therapy, fewer cesarean sections, and the reduced use of cephalosporin in very preterm infants may reduce CRAB VAP. |
Author | Thatrimontrichai, Anucha Kritsaneepaiboon, Supika Janjindamai, Waricha Maneenil, Gunlawadee Techato, Chirabat Dissaneevate, Supaporn Tanaanantarak, Pattama |
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BackLink | https://www.ncbi.nlm.nih.gov/pubmed/27229539$$D View this record in MEDLINE/PubMed |
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Keywords | Carbapenem Colonization pressure Acinetobacter baumannii Pneumonia Newborn Drug resistance |
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Snippet | Abstract Background Carbapenem-resistant and susceptible Acinetobacter baumannii (CRAB and CSAB) have emerged as serious threats among critically ill neonates.... Carbapenem-resistant and susceptible Acinetobacter baumannii (CRAB and CSAB) have emerged as serious threats among critically ill neonates. We aimed to... BACKGROUNDCarbapenem-resistant and susceptible Acinetobacter baumannii (CRAB and CSAB) have emerged as serious threats among critically ill neonates. We aimed... Background: Carbapenem-resistant and susceptible Acinetobacter baumannii (CRAB and CSAB) have emerged as serious threats among critically ill neonates. We... |
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SubjectTerms | Acinetobacter baumannii Acinetobacter baumannii - drug effects Acinetobacter Infections - drug therapy Anti-Bacterial Agents - therapeutic use Carbapenem Carbapenems - therapeutic use Case-Control Studies Cephalosporins - administration & dosage Colonization pressure Decapoda Drug resistance Drug Resistance, Bacterial Female Hematology, Oncology and Palliative Medicine Humans Infant Infant, Newborn Male Newborn Pneumonia Pneumonia, Ventilator-Associated - drug therapy Pneumonia, Ventilator-Associated - epidemiology Pneumonia, Ventilator-Associated - microbiology Pulmonary Surfactants - administration & dosage Risk Factors Treatment Outcome |
Title | Risk factors and outcomes of carbapenem-resistant Acinetobacter baumannii ventilator-associated pneumonia in the neonate: A case-case-control study |
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