Treatment of ventilator-associated pneumonia (VAP) caused by Acinetobacter: results of prospective and multicenter ID-IRI study

Erdem H. | Cag Y. | Gencer S. | Uysal S. | Karakurt Z. | Harman R. | Aslan E.

Article | 2019 | European Journal of Clinical Microbiology and Infectious Diseases

Ventilator-associated pneumonia (VAP) due to Acinetobacter spp. is one of the most common infections in the intensive care unit. Hence, we performed this prospective-observational multicenter study, and described the course and outcome of the disease. This study was performed in 24 centers between January 06, 2014, and December 02, 2016. The patients were evaluated at time of pneumonia diagnosis, when culture results were available, and at 72 h, at the 7th day, and finally at the 28th day of follow-up. Patients with coexistent infections were excluded and only those with a first VAP episode were enrolled. Logistic regression analysi . . .s was performed. A total of 177 patients were included; empiric antimicrobial therapy was appropriate (when the patient received at least one antibiotic that the infecting strain was ultimately shown to be susceptible) in only 69 (39%) patients. During the 28-day period, antibiotics were modified for side effects in 27 (15.2%) patients and renal dose adjustment was made in 38 (21.5%). Ultimately, 89 (50.3%) patients died. Predictors of mortality were creatinine level (OR, 1.84 (95% CI 1.279–2.657); p = 0.001), fever (OR, 0.663 (95% CI 0.454–0.967); p = 0.033), malignancy (OR, 7.095 (95% CI 2.142–23.500); p = 0.001), congestive heart failure (OR, 2.341 (95% CI 1.046–5.239); p = 0.038), appropriate empiric antimicrobial treatment (OR, 0.445 (95% CI 0.216–0.914); p = 0.027), and surgery in the last month (OR, 0.137 (95% CI 0.037–0.499); p = 0.003). Appropriate empiric antimicrobial treatment in VAP due to Acinetobacter spp. was associated with survival while renal injury and comorbid conditions increased mortality. Hence, early diagnosis and appropriate antibiotic therapy remain crucial to improve outcomes. © 2019, Springer-Verlag GmbH Germany, part of Springer Nature Daha fazlası Daha az

Acinetobacter co-infection and coagulase-negative Staphylococcus: case report and literature review

Elsurer, Rengin | Afsar, Baris

Article | 2010 | RENAL FAILURE32 ( 4 ) , pp.515 - 517

Continuous ambulatory peritoneal dialysis (CAPD) is a safe, convenient, and cost-effective therapy in end-stage renal disease. The major complication of peritoneal dialysis (PD) is peritonitis. Gram-positive cocci are isolated in majority of the episodes. Among gram-negative bacteria, Acinetobacter species have been reported in peritonitis, sometimes as a concomitant that may be asymptomatic and require no treatment. Little has been written about the clinical features and outcome of PD-related peritonitis caused by co-infection of Acinetobacter species with other pathogens. We herein present a case of peritonitis caused by co-infect . . .ion with Acinetobacter species and coagulase-negative staphylococci, which resulted in patient dropout and mortality. We review the literature about Acinetobacter peritonitis and current treatment protocols Daha fazlası Daha az

Activity of a dry mist-generated hydrogen peroxide disinfection system against methicillin-resistant Staphylococcus aureus and Acinetobacter baumannii

Piskin N. | Celebi G. | Kulah C. | Mengeloglu Z. | Yumusak M.

Conference Object | 2011 | American Journal of Infection Control39 ( 9 ) , pp.757 - 762

Background: The aim of this study was to evaluate the activity of a dry mist-generated hydrogen peroxide (DMHP) system (Sterinis; Gloster Sante Europe, Labege cedex, France) against methicillin-resistant Staphylococcus aureus (MRSA) and Acinetobacter baumannii. Methods: McFarland 0.5 suspensions of 2 test bacteria, either pure or containing 5% sterile serum, were prepared and inoculated onto sterile stainless steel disks. Each disk in a Petri dish - with the Petri dish cover either closed or open - was placed in different locations in an intensive care unit room. Quantitative cultures were performed after the cycle. Results: No grow . . .th occurred on the disks in the absence of a barrier, except 1 disk containing serum. Existence of a barrier, as a drawer or a covered Petri dish, caused failure in the disinfection activity. The mean reduction in initial log 10 bacterial count was lower for both of the test bacteria in presence of a barrier: 4.44- to 4.70-log 10 colony-forming units (cfu) decrease was observed in absence of a barrier, whereas 1.49- to 3.79-log 10 cfu decrease was observed in presence of a barrier. When the culture results were compared according to organic load content, the mean (±standard deviation) reduction of initial contamination in pure and in serum containing MRSA suspensions was 4.25 ± 1.20- and 3.34 ± 1.89-log 10 cfu, respectively. The mean (±standard deviation) reduction in pure and in serum containing A baumannii suspensions was 4.34 ± 0.89- and 3.87 ± 1.26-log 10 cfu, respectively. The differences were statistically significant (P <.001). Conclusion: Sterinis was capable of killing MRSA and A baumannii on open surfaces; however, it was not effective in closed or semiclosed areas. Presence of serum also caused failure in the disinfection activity of the system. Copyright © 2011 by the Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved Daha fazlası Daha az

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