dc.creator | Álvarez Marín, Rocío | es |
dc.creator | López-Rojas, Rafael | es |
dc.creator | Márquez, Juan Antonio | es |
dc.creator | Gómez Gómez, María José | es |
dc.creator | Molina Gil-Bermejo, José | es |
dc.creator | Cisneros, José Miguel | es |
dc.creator | Aznar Martín, Javier | es |
dc.creator | Pachón Díaz, Jerónimo | es |
dc.date.accessioned | 2020-04-29T11:09:37Z | |
dc.date.available | 2020-04-29T11:09:37Z | |
dc.date.issued | 2016 | |
dc.identifier.citation | Álvarez Marín, R., López-Rojas, R., Márquez, J.A., Gómez Gómez, M.J., Molina Gil-Bermejo, J., Cisneros, J.M.,...,Pachón Díaz, J. (2016). 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, 11 (12), 1-12 p.. | |
dc.identifier.issn | 1932-6203 | es |
dc.identifier.uri | https://hdl.handle.net/11441/95956 | |
dc.description.abstract | Objectives
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. bau-
mannii strains, 99% were non-susceptible to carbapenems and the MIC 90 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 set-
ting of high susceptibility to colistin of A. baumannii. | es |
dc.description.sponsorship | Ministerio de Economía y Competitividad REIPI RD12/ 0015/0001 | es |
dc.format | application/pdf | es |
dc.format.extent | 12 | es |
dc.language.iso | eng | es |
dc.publisher | Public Library Of Science. | es |
dc.relation.ispartof | Plos One, 11 (12), 1-12 p.. | |
dc.rights | Attribution-NonCommercial-NoDerivatives 4.0 Internacional | * |
dc.rights.uri | http://creativecommons.org/licenses/by-nc-nd/4.0/ | * |
dc.subject | Acinetobacter baumannii Ventilator. | es |
dc.subject | Pneumonia. | es |
dc.subject | High Susceptibility to Colistin. | es |
dc.title | Colistin Dosage without Loading Dose Is Efficacious when Treating Carbapenem- Resistant Acinetobacter baumannii Ventilator- Associated Pneumonia Caused by Strains with High Susceptibility to Colistin | es |
dc.type | info:eu-repo/semantics/article | es |
dcterms.identifier | https://ror.org/03yxnpp24 | |
dc.type.version | info:eu-repo/semantics/publishedVersion | es |
dc.rights.accessRights | info:eu-repo/semantics/openAccess | es |
dc.contributor.affiliation | Universidad de Sevilla. Departamento de Medicina. | es |
dc.contributor.affiliation | Universidad de Sevilla. Departamento de Microbiología | es |
dc.identifier.doi | 10.1371/journal.pone.0168468 | es |
dc.contributor.group | Universidad de Sevilla. CTS203: Estudio de las enfermedades infecciosas. | es |
dc.journaltitle | Plos One | es |
dc.publication.volumen | 11 | es |
dc.publication.issue | 12 | es |
dc.publication.initialPage | 1 | es |
dc.publication.endPage | 12 p. | es |