Evaluation of clinical characteristics and treatment response of patients with acinetobacter baumannii isolated in respiratory intensive care unit

Aim: Acinetobacter baumannii is one of the important nosocomial pathogens. Acinetobacter infections cause prolonged hospital stay, mortality and morbidity. In this study, we aimed to evaluate demographic data, risk factors effective on mortality, clinical characteristics and response to treatment results of A. baumannii breeding patients in culture results studied in our respiratory intensive care unit. Material and Method: The study was conducted between January 2015 and 2017 at Dicle University Faculty of Medicine Pulmonary Diseases Respiratory Intensive Care Unit (ICU). Patients with at least 48 hours hospitalization in the respiratory intensive care unit and those with A. baumannii growth in culture results were included in the study. Demographic characteristics of the patients, drugs used, comorbidities, clinical and laboratory findings, hospitalization times and hospitalized medical treatments, NIMV / IMV requirements, invasive and noninvasive procedures (tracheostomy, urinary catheter, intubation, mechanical ventilator, tracheostomy, central venous catheter, nasogastric catheter) were evaluated retrospectively from records. APACHE II, SOFA and GCS values were calculated by looking at the parameters of the first day of ICU admission. Clinical and laboratory findings of the patients were recorded on the first day of reproduction of A. baumannii and on the fifth day of treatment. Results: 97 patients with A. baumanni growth in their respiratory ICU cultures, 64 (65.8%) were male and 33 (34.2%) were female. The mean age was 66.2 ± 20.1 years. 89 (91.8%) of the patients were hospitalized in another clinic before coming to the ICU. In the last three months, 4 (4.1%) patients had a history of systemic steroid use. All patients received antibiotic treatment within 48 hours. 93.8% of the patients had comorbidities. A. baumanni was isolated from 60% DTA, 22% blood culture, 8% urine culture, 4% catheter and 3% wound site, respectively. Vasopressor agent (noradrenaline) was given to 67% of the patients after A. baumanni growth. Overall mortality rate was 84.5%; The 30-day mortality rate was 54.6%. The mean length of hospital stay (69.7 ± 17 days) was higher in the ICU (p <0.001). NIMV and IMV implementation time were longer in patients who died (p <0.001). No effect of APACHE II, SOFA and GCS scores on mortality was observed (p = 0.723, p = 0.307, p = 0.517, respectively).