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Updated: Mar 28, 2026
Murine Oropharyngeal Aspiration Model of Ventilator-associated and Hospital-acquired Bacterial Pneumonia
Published on: June 28, 2018
Incidence and predictors of 14-day mortality in multidrug-resistant Acinetobacter baumannii in ventilator-associated
Basima Abdalla Almomani1, Amanda McCullough, Rawan Gharaibeh
1Jordan University of Science and Technology, Irbid, Jordan. baalmomani1@just.edu.jo.
Introduction:
Ventilator-associated pneumonia (VAP) caused by multidrug-resistant Acinetobacter baumannii (MDR-AB) is common in hospitals and impacts patient survival. We determined the incidence of MDR-AB VAP in critical care units and examined the predictors of 14-day mortality in these patients.
Methodology:
A retrospective case series study was conducted at a tertiary referral teaching hospital in north Jordan. A list of patients with a positive culture of A. baumannii between January 2007 and June 2013 was retrieved using computerized hospital databases. Medical records of all these patients were reviewed, and cases of VAP infected with MDR-AB were identified. Predictors of 14-day mortality were determined using multivariable logistic regression adjusted for possible confounders.
Results:
Out of 121 A. baumannii-VAP cases, 119 (98.3%) were caused by MDR-AB. The incidence rate of MDR-AB VAP was 1.59 cases per 100 critical care unit admissions. The mortality of A. baumannii-VAP cases in critical care units was 42% (50/119). Being prescribed two or more definitive antibiotics (prescribed based on susceptibility data) (OR = 0.075, 95% CI = 0.017-0.340, p = 0.001) and ipratropium/salbutamol during mechanical ventilation (OR = 0.140, 95% CI = 0.028-0.705, p = 0.017) were independently associated with lower hospital mortality.
Conclusions:
Our results suggest incidence of MDR-AB VAP in critical care units is high and that prescription of antibiotics based on antibiotic susceptibility and use of bronchodilators is associated with lower mortality in this population. Larger prospective studies are needed to explore whether these findings can be replicated in different clinical settings.
Insights
Multidrug-resistant Acinetobacter baumannii ventilator-associated pneumonia (MDR-AB VAP) is a significant threat in ICUs. Targeted antibiotic therapy and bronchodilator use were linked to reduced mortality in MDR-AB VAP patients.
Area of Science:
- Infectious Diseases
- Critical Care Medicine
- Microbiology
Background:
- Ventilator-associated pneumonia (VAP) caused by multidrug-resistant Acinetobacter baumannii (MDR-AB) presents a substantial challenge in intensive care units (ICUs), impacting patient survival.
- The study addresses the critical need to understand the epidemiology and risk factors associated with MDR-AB VAP.
Purpose of the Study:
- To determine the incidence of MDR-AB VAP in critical care units.
- To identify predictors of 14-day mortality in patients with MDR-AB VAP.
Main Methods:
- A retrospective case series design was employed at a tertiary referral teaching hospital in north Jordan.
- Data were collected from January 2007 to June 2013, identifying MDR-AB VAP cases from computerized hospital databases and reviewing medical records.
- Multivariable logistic regression was used to analyze predictors of 14-day mortality, adjusting for potential confounders.
Main Results:
- Nearly all (98.3%) A. baumannii VAP cases were attributed to MDR strains, with an incidence of 1.59 cases per 100 ICU admissions.
- The overall mortality rate for A. baumannii VAP was 42%.
- Prescribing two or more definitive antibiotics based on susceptibility data and the use of ipratropium/salbutamol during mechanical ventilation were independently associated with significantly lower hospital mortality.
Conclusions:
- The incidence of MDR-AB VAP in critical care settings is notably high.
- Antibiotic therapy guided by susceptibility testing and the use of bronchodilators appear to be protective factors, potentially reducing mortality in this patient population.
- Further large-scale prospective studies are warranted to validate these findings across diverse clinical environments.
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