Analysis of applied empirical treatments against VAP caused by Acinetobacter baumannii

Aneta Grochowalska 1  ,  
Laboratorium Mikrobiologii, Mazowiecki Szpital Specjalistyczny w Radomiu
Państwowa Szkoła Wyższa im. Papieża Jana Pawła II w Białej Podlaskiej
MONZ 2017;23(3):189–195
The aim of the study was analysis of A. baumannii strains, isolated from hospital samples from the lower respiratory tract collected from patients with VAP hospitalized in Masovian Specialist Hospital’s ICU in Radom between 2012 and 2014. The frequency of occurrence and drug susceptibility of these bacteria was evaluated, as well as the applied empirical treatment and its effectiveness in ICU with the recommendations in effect.

Material and methods:
Retrospective study was conducted during the period from 1 January – 31 December 2014, in ICU among patients with the diagnosis of VAP, aggravating factors were analyzed and A.baumannii isolated.

Studies included 755 patients with the suspicion of VAP. A. baumannii was isolated in 141 patients with confirmed VAP. Moreover, in the examined group, in 34 patients in addition to A. baumannii another strain was isolated, considered as etiological factor participating in coinfection. A considerable part of A. baumannii strains were characterized by high resistance (> 90%) to selected antibiotics. Analysis of the empirical treatment applied showed that the level of accuracy of therapy for A. baumannii in early VAP was 31%, and for the remaining strains – 57%, while in late VAP the sensitivity of A. baumannii was 11% and for the species causing coinfection – 24%. In patients with an early diagnosis of VAP, after targeted antibiotic therapy an improvement of clinical condition was observed in 35% of patients, whereas in those with late diagnosis – in 61% of patients.

In the conducted study, infections caused by multi-resistant A. baumannii were observed more frequently in late VAP, which should be taken into consideration while choosing empirical antibiotic therapy. Simultaneously, the local resistance patterns of multi-drug-resistant Gram-negative strains co-infecting VAP should be considered in empirical treatment. Moreover, both additional clinical complication and co-infections contribute to more severe course of diseases.

Aneta Grochowalska   
Laboratorium Mikrobiologii, Mazowiecki Szpital Specjalistyczny w Radomiu, Aleksandrowicza 5, 26-617 Radom, Polska
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