Prospective study of risk factors for ventilator-associated pneumonia caused by Acinetobacter species

SummaryThe incidence of ventilator-associated pneumonia (VAP) by Acinetobacter spp (VAPA) is increasing and has high morbidity and mortality. It is imperative to identify risk factors to be able to use prevention policies.ObjectiveThe aim of this study was to identify specific risk factors for VAPA.DesignProspective cohort study.InterventionsNone.SettingTwo medical-surgical intensive care units.MeasurementsDuring a period of 36 months, all patients with more than 48 hours on mechanical ventilation and suspected of having a VAP were enrolled. Only VAP with microbiological confirmation was analyzed.ResultsTwo hundred eighteen consecutive patients with clinical suspicion of VAP were enrolled. One hundred twenty-five VAPs were confirmed by culture—46 by Acinetobacter spp and 79 by other pathogens.The 36 potential risk factors for Acinetobacter spp were analyzed by univariate analysis.Logistic regression identified previous use of ceftriaxone (relative risk, 5.1; 95% confidence interval, 1.47-17.82) and previous use of ciprofloxacin (relative risk, 9.1; 95% confidence interval, 2.29-36.63) as significant independent predictors for the development of VAPA.ConclusionsPrevious use of ceftriaxone and ciprofloxacin are independent risk factors for the development of VAPA.