Risk factors and outcome of Acinetobacter baumanii infection in severe trauma patients

Anselmo Caricato, Luca Montini, Vincenzo Michetti, Massimo Antonelli, Giuseppe Bello, Riccardo Maviglia, Maria Grazia Bocci, Giovanna Mercurio, Salvatore Maurizio Maggiore

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26 Citations (Scopus)

Abstract

OBJECTIVE: To investigate incidence, risk factors and outcome of Acinetobacter baumanii infection in trauma patients. DESIGN AND SETTING: A retrospective analysis of prospectively collected data of all trauma patients admitted to a general intensive care unit (ICU) of a 1,500-bed university hospital over 3 years. PATIENTS: Three hundred thirty trauma patients were included in the study. RESULTS: Thirty-six (10.9%) cases of A. baumanii infection were observed; 29 of them were late onset pneumonia. Patients with A. baumanii infection had a significantly higher Injury Severity Score (ISS) (p = 0.02), a lower Glasgow Coma Scale (GCS) on ICU admission (p = 0.03), stayed longer in the ICU (p = 0.00001), were mechanically ventilated for a longer period of time (p = 0.00001), were more frequently admitted to the emergency department with hypotension (p = 0.02), and had trans-skeletal traction for more than 3 days (p = 0.003) in comparison to the 294 patients who did not develop A. baumanii infection. At multivariate analysis the time spent on mechanical ventilation (p = 0.02) and the presence of long-term trans-skeletal traction (p = 0.04) were the only independent risk factors for A. baumanii infection. Patients with A. baumanii infection had a high mortality rate (9 out of 36; 25.0%). ISS (p = 0.003), GCS (p = 0.001) and older age (p = 0.00001), but not A. baumanii infection (p = 0.15), were independently correlated with mortality. CONCLUSIONS: In trauma patients prolonged mechanical ventilation and delayed fracture fixation with the persistence of trans-skeletal traction were major risk factors for A. baumanii infection. The presence of this infection was not correlated with mortality. PMID: 19652951 DOI: 10.1007/s00134-009-1582-5
Original languageEnglish
Pages (from-to)1964-1969
Number of pages6
JournalIntensive Care Medicine
Volume35
DOIs
Publication statusPublished - 2009

Keywords

  • Acinetobacter Infections
  • Acinetobacter baumannii
  • Adult
  • Aged
  • Chi-Square Distribution
  • Critical Care
  • Cross Infection
  • Glasgow Coma Scale
  • Hospital Mortality
  • Hospitals, University
  • Humans
  • Incidence
  • Infection Control
  • Injury Severity Score
  • Length of Stay
  • Linear Models
  • Logistic Models
  • Middle Aged
  • Multiple Trauma
  • Multivariate Analysis
  • Respiration, Artificial
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Rome
  • Statistics, Nonparametric
  • Traction
  • Treatment Outcome

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