The Burden of Carbapenem-Resistant Acinetobacter baumannii in ICU COVID-19 Patients: A Regional Experience.
In: Journal of Clinical Medicine, Jg. 11 (2022-09-01), Heft 17, S. 5208-5218
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Zugriff:
Since the beginning of the COVID-19 pandemic, the impact of superinfections in intensive care units (ICUs) has progressively increased, especially carbapenem-resistant Acinetobacter baumannii (CR-Ab). This observational, multicenter, retrospective study was designed to investigate the characteristics of COVID-19 ICU patients developing CR-Ab colonization/infection during an ICU stay and evaluate mortality risk factors in a regional ICU network. A total of 913 COVID-19 patients were admitted to the participating ICUs; 19% became positive for CR-Ab, either colonization or infection (n = 176). The ICU mortality rate in CR-Ab patients was 64.7%. On average, patients developed colonization or infection within 10 ± 8.4 days from ICU admission. Scores of SAPS II and SOFA were significantly higher in the deceased patients (43.8 ± 13.5, p = 0.006 and 9.5 ± 3.6, p < 0.001, respectively). The mortality rate was significantly higher in patients with extracorporeal membrane oxygenation (12; 7%, p = 0.03), septic shock (61; 35%, p < 0.001), and in elders (66 ± 10, p < 0.001). Among the 176 patients, 129 (73%) had invasive infection with CR-Ab: 105 (60.7%) Ventilator-Associated Pneumonia (VAP), and 46 (26.6%) Bloodstream Infections (BSIs). In 22 cases (6.5%), VAP was associated with concomitant BSI. Colonization was reported in 165 patients (93.7%). Mortality was significantly higher in patients with VAP (p = 0.009). Colonized patients who did not develop invasive infections had a higher survival rate (p < 0.001). Being colonized by CR-Ab was associated with a higher risk of developing invasive infections (p < 0.001). In a multivariate analysis, risk factors significantly associated with mortality were age (OR = 1.070; 95% CI (1.028–1.115) p = 0.001) and CR-Ab colonization (OR = 5.463 IC95% 1.572–18.988, p = 0.008). Constant infection-control measures are necessary to stop the spread of A. baumannii in the hospital environment, especially at this time of the SARS-CoV-2 pandemic, with active surveillance cultures and the efficient performance of a multidisciplinary team. [ABSTRACT FROM AUTHOR]
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The Burden of Carbapenem-Resistant Acinetobacter baumannii in ICU COVID-19 Patients: A Regional Experience.
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Autor/in / Beteiligte Person: | Montrucchio, Giorgia ; Corcione, Silvia ; Lupia, Tommaso ; Shbaklo, Nour ; Olivieri, Carlo ; Poggioli, Miriam ; Pagni, Aline ; Colombo, Davide ; Roasio, Agostino ; Bosso, Stefano ; Racca, Fabrizio ; Bonato, Valeria ; Della Corte, Francesco ; Guido, Stefania ; Della Selva, Andrea ; Ravera, Enrico ; Barzaghi, Nicoletta ; Cerrano, Martina ; Caironi, Pietro ; Berta, Giacomo |
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Zeitschrift: | Journal of Clinical Medicine, Jg. 11 (2022-09-01), Heft 17, S. 5208-5218 |
Veröffentlichung: | 2022 |
Medientyp: | academicJournal |
ISSN: | 2077-0383 (print) |
DOI: | 10.3390/jcm11175208 |
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