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Murine Oropharyngeal Aspiration Model of Ventilator-associated and Hospital-acquired Bacterial Pneumonia
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Acinetobacter baumannii among Patients Receiving Glucocorticoid Aerosol Therapy during Invasive Mechanical

Wenchao Zhang, Mei Yin, Wei Li

    Emerging Infectious Diseases
    |November 23, 2022
    PubMed

    Insights

    Glucocorticoid aerosol therapy in ventilated patients is linked to increased Acinetobacter baumannii isolation. While not directly causing mortality, A. baumannii isolation independently predicts 30-day mortality in these patients.

    Area of Science:

    • Infectious Diseases
    • Critical Care Medicine
    • Pharmacology

    Background:

    • Acinetobacter baumannii is a significant cause of hospital-acquired infections, particularly in intensive care units.
    • Invasive mechanical ventilation is a common procedure for critically ill patients.
    • Glucocorticoid aerosol therapy is frequently used in mechanically ventilated patients.

    Purpose of the Study:

    • To investigate the association between glucocorticoid aerosol therapy and Acinetobacter baumannii isolation in mechanically ventilated patients.
    • To determine if glucocorticoid aerosol therapy is an independent risk factor for A. baumannii isolation.
    • To assess the impact of A. baumannii isolation on 30-day mortality in this patient population.

    Main Methods:

    • Prospective cohort study design.
    • Enrollment of 497 patients receiving invasive mechanical ventilation.
    • Analysis of glucocorticoid aerosol use and A. baumannii isolation rates.
    • Statistical analysis including hazard ratios and confidence intervals.

    Main Results:

    • Glucocorticoid aerosol therapy was administered to 262 (52.7%) patients.
    • A. baumannii was isolated from 159 (32.0%) patients.
    • Glucocorticoid aerosol therapy was an independent risk factor for A. baumannii isolation (HR 1.5, 95% CI 1.02-2.28; p = 0.038).
    • A. baumannii isolation, not glucocorticoid aerosol, was independently associated with 30-day mortality.

    Conclusions:

    • Glucocorticoid aerosol therapy is associated with an increased risk of Acinetobacter baumannii isolation in mechanically ventilated patients.
    • Physicians should be aware of this association and consider potential A. baumannii infections when prescribing glucocorticoid aerosols.
    • A. baumannii isolation is a significant predictor of mortality in this vulnerable patient group.
    Keywords:
    Acinetobacter baumanniiChinaaerosol inhalationantimicrobial resistancebacteriaglucocorticoidhealthcare-associated infectionsinvasive mechanical ventilation

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