The effect of acinetobacter colonization and infection on prognosis and in-hospital mortality of patients hospitalized in the pulmonary diseases unit

Objective: In this study, it was aimed to determine the effect of selected parameters on mortality in patients with Acinetobacter growth in samples taken from the lower respiratory tract. Materials and Methods: Between 01.01.2015-05.03.2019, the files of 173 patients hospitalized in Zonguldak Bülent Ecevit University Practice and Research Hospital Pulmonary Diseases service and intensive care unit and who had Acinetobacter growth in sputum, tracheal aspirate or bronchial lavage culture were analyzed retrospectively. 22 patients were excluded for various reasons. The data of 152 cases in total was reached. Clinical and laboratory parameters that may affect mortality were evaluated. The patients were grouped and compared, to be died during the hospitalization and discharged. Findings: 152 patients (107 male (70.4%) and 45 female (29.6%)) were included in the study. The median age of all patients was 77 (31-69). 93 (61.1%) of the patients had history of smoking. 59.2% (n = 90) of the patients died during hospitalization, 40.8% (n = 62) of the patients were discharged after their treatment. When the patients who died and were discharged compared, there were no significant difference between the groups in age and gender (p = 0.133 and p = 0.958, respectively). Some of the patients had comorbid diseases, but there was no difference between the groups. Acinetobacter growth was evaluated as colonization in 37 patients (24.3%). Acinetobacter growth was evaluated as colonization in 8 (8.9%) patients who died and 29 (46.8%) patients who were discharged. There was a significant difference in colonization between the groups (p <0.001). The median day of growth since hospitalization was 9 (1-51). 74 patients (48.7%) received combination therapy of meropenem and colistin, there was a significant difference between the groups in antibiotic selection (p = 0.018). The vital values of the patients at the time of growth were examined, it was seen that only the peak heart rate was higher in the group who died than the group discharged (p = 002). GCS was found to be significantly low and SOFA and PSI scores were high in those who lost their lives (p <0.001). Urea and creatinine levels were found to be elevated after treatment. It was found that the increase of urea after treatment increased the mortality risk 1.019 times (p = 0.003) and in the intubated group, the mortality risk was 7.252 times higher (p = 0.003) than non-intubated ones. Mortality risk was higher in those who received dopamine and noradrenaline. Other variables were not found to be significant risk factors on mortality Result: Certain parameters that are thought to be related to mortality in patients with Acinetobacter factor growth in the respiratory tract were examined. The poor course of the disease, progression to the septic state, hypotension and nephrotoxic treatment cause urea height. Urea height, intubation, dopamine and noradrenaline use were found to be associated with mortality. Keywords: Acinetobacter, colistin, hospital acquired pneumonia, mechanical ventilation, mortality