Journal
EMERGING INFECTIOUS DISEASES
Volume 28, Issue 12, Pages 2398-2408Publisher
CENTERS DISEASE CONTROL & PREVENTION
DOI: 10.3201/eid2812.220347
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Funding
- National Natural Science Foundation of China [81873927, 82072231]
- Taishan Scholars Program of Shandong Province [tsqn202103165]
- Clinical Research Center of Shandong University [2020SDUCRCC013]
- Natural Science Foundation of Shandong Province [ZR2020QH021]
- China Postdoctoral Science Foundation [2018M632685]
- Project of Science and Technology of Qingdao People's Livelihood [19-6-1-23-nsh]
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Glucocorticoid aerosol therapy is associated with increased risk of A. baumannii isolation in ventilator patients, which in turn is independently associated with 30-day mortality. Physicians should be cautious when prescribing glucocorticoid aerosol therapy, considering the potential risk of A. baumannii infection.
Acinetobacter baumannii is a nosocomial pathogen associated with severe illness and death. Glucocorticoid aerosol is a common inhalation therapy in patients receiving invasive mechanical ventilation. We conducted a prospective cohort study to analyze the association between glucocorticoid aerosol therapy and A. baumannii isolation from ventilator patients in China. Of 497 enrolled patients, 262 (52.7%) received glucocorticoid aerosol, and A. baumannii was isolated from 159 (32.0%). Glucocorticoid aerosol therapy was an independent risk factor for A. baumannii isolation (hazard ratio 1.5, 95% CI 1.02-2.28; p = 0.038). Patients receiving glucocorticoid aerosol had a higher cumulative hazard for A. baumannii isolation and analysis showed that glucocorticoid aerosol therapy increased A. baumannii isolation in most subpopulations. Glucocorticoid aerosol was not a direct risk factor for 30-day mortality, but A. baumannii isolation was independently associated with 30-day mortality in ventilator patients. Physicians should consider potential A. baumannii infection when prescribing glucocorticoid aerosol therapy.
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