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Korean J Crit Care Med > Volume 28(3); 2013 > Article
Korean Journal of Critical Care Medicine 2013;28(3): 173-179. doi: https://doi.org/10.4266/kjccm.2013.28.3.173
인공호흡기 치료 중 기관 분비물 배양 검사에서 Carbapenem-Resistant Acinetobacter baumannii가 동정된 환자의 임상적 특성
목정하ㆍ김미현ㆍ이광하ㆍ김기욱ㆍ박혜경ㆍ이민기
부산대학교 의학전문대학원 내과학교실
Clinical Characteristics in Patients with Carbapenem-Resistant Acinetobacter baumannii Isolates from Tracheal Secretions
Jeong Ha Mok, Mi Hyun Kim, Kwangha Lee, Ki Uk Kim, Hye Kyung Park, Min Ki Lee
Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea. jubilate@pusan.ac.kr
ABSTRACT
BACKGROUND: This study was conducted to evaluate the clinical characteristics and outcomes of mechanically ventilated patients with carbapenem-resistant Acinetobacter baumannii (CRAB) isolates from tracheal secretions in a medical intensive care unit (ICU) of a university hospital. METHODS: We conducted a retrospective study from January 2009 to June 2012. RESULTS: Among the patients who had isolates cultured from tracheal secretions, 130 patients (34.8%) had CRAB isolates. Their mean age was 65 +/- 14 yr and 74.6% were male. The ICU and hospital mortality was 51.5% and 60.0%, respectively. According to physician's clinical decision, antibiotics were changed in order to cover CRAB in 75 (57.7%) patients. The total duration of antibiotics use was 12.2 +/- 8.1 days. Of patients with antibiotics change to cover CRAB, 70 patients (93.3%) had Clinical Pulmonary Infection Score of 6 and over. However, there was no significant difference in hospital mortality between patients with antibiotics change against CRAB and those without change. In multivariable analysis, only Acute Physiology and Chronic Health Evaluation II score was related to hospital mortality of patients with CRAB. CONCLUSIONS: In this study, changing antibiotics to cover CRAB by physician's clinical decision only did not influence hospital mortality; further studies would be necessary to investigate how to use antibiotics against CRAB isolates cultured from tracheal secretions.
Key Words: Acinetobacter baumannii; carbapenem; intensive care unit
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