RT Journal Article
T1 Colistin Dosage without Loading Dose Is Efficacious when Treating Carbapenem-Resistant Acinetobacter baumannii Ventilator-Associated Pneumonia Caused by Strains with High Susceptibility to Colistin.
A1 Álvarez-Marín, Rocío
A1 López-Rojas, Rafael
A1 Márquez, Juan Antonio
A1 Gómez, María José
A1 Molina, José
A1 Cisneros, José Miguel
A1 Ortiz-Leyba, Carlos
A1 Aznar, Javier
A1 Garnacho-Montero, José
A1 Pachón, Jerónimo
K1 Acinetobacter baumannii
K1 Lesión renal aguda
K1 Antibacterianos
K1 Bacteriemia
K1 Colistina
K1 Unidades de cuidados intensivos
AB This study aims to analyze the mortality and the length of ICU stay (LOS) of A. baumannii VAP compared to respiratory colonization in patients with mechanical ventilation (MV).METHODS:A prospective cohort study was performed in an ICU of adult patients (February 2010-June 2011). One hundred patients on MV with A. baumannii in lower respiratory airways were recruited, and classified as VAP or airways colonization according to CPIS criteria, with a punctuation ≥6. LOS, 30-days mortality, A. baumannii bacteremia, and clinical features including antibiotic therapy were recorded. Multivariate analysis (linear and Cox regression) and survival analysis (Kaplan-Meier curves) were performed.RESULTS:Fifty-seven VAP and 43 colonized A. baumannii patients were analyzed. Among the A. baumannii strains, 99% were non-susceptible to carbapenems and the MIC90 of colistin was 0.12 mg/l. Therapy was appropriate in 94.6% of VAP patients, most of them with colistin 6 MIU/day, although in 13 (23.6%) cases colistin was started 48 hours after the onset of VAP. Mortality was similar in both groups (VAP 24.6% vs. colonized 27.9%, p = 0.7). Bacteremia and acute kidney insufficiency were associated with decreased survival (p = 0.02 and p = 0.04, respectively) in VAP patients. LOS was 21.5 (11.5-42.75) vs. 9 (6-22) days for VAP and colonized patients (p = 0.004). VAP (p = 0.003) and age (p = 0.01) were independently related to a longer LOS.CONCLUSIONS:Multidrug-resistant A. baumannii VAP treated with colistin does not have a different mortality compared to lower airways colonization, among patients on mechanical-ventilation, in a setting of high susceptibility to colistin of A. baumannii.
PB Public Library of Science
YR 2016
FD 2016-12-19
LK http://hdl.handle.net/10668/2595
UL http://hdl.handle.net/10668/2595
LA en
NO Álvarez-Marín R, López-Rojas R, Márquez JA, Gómez MJ, Molina J, Cisneros JM, et al. Colistin Dosage without Loading Dose Is Efficacious when Treating Carbapenem-Resistant Acinetobacter baumannii Ventilator-Associated Pneumonia Caused by Strains with High Susceptibility to Colistin. PLoS One. 2016;11(12):e0168468.
DS RISalud
RD Apr 18, 2025