Candida spp. Airway colonization: A potential risk factor for acinetobacter baumannii ventilator-associated pneumonia

Xiaojiang Tan, Song Zhu, Dongxing Yan, Weiping Chen, Ruilan Chen, Jian Zou, Jingdong Yan, Xiangdong Zhang, Dimitrios Farmakiotis, Eleftherios Mylonakis

Research output: Contribution to journalArticlepeer-review

25 Scopus citations

Abstract

This retrospective study was conducted to identify potential risk factors for Acinetobacter baumannii (A. baumannii) ventilator-associated pneumonia (VAP) and evaluate the asso- ciation between Candida spp. airway colonization and A. baumannii VAP. Intensive care unit (ICU) patients who were on mechanical ventilation (MV) for ≥48 hours were divided into the following groups: patients with and without Candida spp. airway colonization; colonized patients receiving antifungal treatment or not; patients with A. baumannii VAP and those without VAP. Logistic regression analysis and propensity score matching were used to identify factors independently associated with A. baumannii VAP. Among 618 eligible patients, 264 (43%) had Candida spp. airway colonization and 114 (18%) devel- oped A. baumannii VAP. Along with MV for ≥7 days (adjusted odds ratio [aOR] 8.9, 95% confidence intervals [95% CI] 4.9-15.8) and presence of a central venous catheter (aOR 3.2, 95% CI 1.1-9), Candida spp. airway colonization (aOR 2.6, 95% CI 1.6-4.3) was iden- tified as an independent risk factor for A. baumannii VAP. Patients with Candida spp. airway colonization were more likely to develop A. baumannii VAP than non-colonized patients (23% vs. 15%, P=.01 and 34% vs. 15%, P<.001 in propensity score-matched subgroups). Administration of antifungal agents was not associated with A. baumannii VAP (29% vs. 21%, P=.153) but with higher in-hospital mortality (53% vs. 39%, P=.037). Candida spp. airway colonization (43%) and A. baumannii VAP (18%) were common in ICU patients who were on mechanical ventilation for at least 48 hours. Candida spp. airway colonization was an independent risk factor for subsequent A. baumannii VAP.

Original languageEnglish (US)
Pages (from-to)557-566
Number of pages10
JournalMedical Mycology
Volume54
Issue number6
DOIs
StatePublished - Aug 1 2016

Keywords

  • Acinetobacter baumannii
  • Candida colonization
  • Intensive care unit
  • Ventilator-associated pneumonia

ASJC Scopus subject areas

  • Infectious Diseases

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