>Year 2018, Issue 3
del Toro CC, Chávez MA, Chávez PJP, López RVM
Evaluation of the isolation of Acinetobacter baumannii and its relationship with the transfusion of blood products in intensive care
Rev Asoc Mex Med Crit y Ter Int 2018; 32 (3)
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The incidence of Acinetobacter baumannii has increased and is associated with greater morbility.
Objective: We determined the incidence of Acinetobacter baumannii isolation in critically ill transfused.
Material and methods: Retrospective cohort, sequential sample from January 2016 to January 2017. We reviewed the information on the records of patients over 15 years of age, men and women, of the local transfusion registry and culture reports. The population was divided into transfused and not transfused to identify the isolation of Acinetobacter baumannii in those transfused. It was analyzed with descriptive statistics, Chi square, Pearson.
Results: 415 critically ill patients, average age: 48 years, main diagnosis upon admission: non-septic, non-surgical (32.5%); most had mechanical ventilation at admission (56.4%); average hospital stay: 6.9 days; transfusion requirement: 29.4%, erythrocytes being 26%, Most of the transfusions were done between day one and four. There was an incidence of Acinetobacter baumannii isolation of 9.8%; the highest number of isolations occurred between days five and eight; they were mainly of bronchial origin. A positive correlation was identified between the isolation and the transfusion of erythrocytes by means of Pearson (p = 0.001), and with mechanical ventilatory assistance, particularly after day 15 (p = 0.0001).
Conclusions: There was a correlation between the transfusion of erythrocytes and the isolation of Acinetobacter baumannii in the population studied.
||Blood transfusion, Acinetobacter baumannii, infection, isolation, association, relationship.
. Ramírez-Sandoval ML, Aranza-Aguilar JL, Varela-Ramírez MA, García-González A, Vélez-Castro G, Salcedo-Romero R, et al. Brote de infección nosocomial de vías respiratorias bajas por Acinetobacter baumannii en un servicio de medicina interna de un hospital general de la Ciudad de México. Med Int Mex. 2013;29(3):250-256.
Karkhane M, Akbariyan M, Mortazavi M, Hossieni K, Pourhoseingholi A, Marzban A, et al. Relationship between blood transfusion and risk of nosocomial infection in intensive care unit patients. Iranian Journal of Clinical Infectious Diseases. 2013;7(1):21-24.
Chacko B, Thomas K, David T, Paul H, Jeyaseelan L, Peter JV. Attributable cost of a nosocomial infection in the intensive care unit: a prospective cohort study. World J Crit Care Med. 2017;6(1):79-84.
Xiao D, Wang L, Zhang D, Xiang D, Liu Q, Xing X. Prognosis of patients with Acinetobacter baumannii infection in the care unit: a retrospective analysis. Exp Ther Med. 2017;13:1630-1633.
Ballouz T, Aridi J, Afif C, Irani J, Lakis C, Nasreddine R, et al. Risk factors, clinical presentation, and outcome of Acinetobacter barumannii bacteremia. Front Cell Infect Microbiol. 2017;4(7):156-166.
Al-Anazi K, Al-Jasser A. Infections caused by Acinetobacter baumannii in recipients of hematopoietic stem cell transplantation. Front Oncol. 2014;4:186.
Marik PE, Corwin HL. Efficacy of red blood cell transfusion in the critically ill: a systematic review of the literature. Crit Care Med. 2008;36(9):2667-2674.
Zheng Y, Caihong L, Shiqing W, Ye L, Lu L, Ping Y. Association of red blood cell transfusion and in-hospital mortality in patients admitted to the intensive care unit: a systematic review and meta-analysis. Critical Care. 2014;18(515):1-14.
Rachoin S, Daher R, Schorr C, Milcarek B, Parrillo E, Gerber D. Microbiology, timer course and clinical characteristics of infection in critically ill patients receiving packed red blood cell transfusion. The International Journal of Transfusion Medicine. 2009;97(4):294-302.
Rohde JM, Dimcheff DE, Blumberg N, Saint S, Langa KM, Kuhn L, et al. Health care-associated infection after red blood cell transfusion: a systematic review and meta-analysis. JAMA. 2014;311(13):1317-1326.
Engele Leo, Straat M, Rooijen I, Vooght K, Cremer O, Schultz M, et al. Transfusion of platelets, but not of red blood cells, is independently associated with nosocomial infections in the critically ill. Ann Intensive Care. 2016;6(67):1-8.
Damgaard C, Magnussen K, Enevold CH, Nilsson M, Tolker T, Holstrup P, et al. Viable bacteria associated with red blood cells and plasma in freshly drawn blood donations. PLOS One. 2015;10(3):e0120826.
Aslam R, Speck E, Kim M, Freedman J, Semple JW. Transfusion-related immunomodulation by platelets is dependent on their expression of MHC Class I molecules and is independent of white cells. Transfusion. 2008;48(9):1778-1786.
Sarani B, Dunkman J, Dean L, Sonnad S, Rohrbach JI, Gracias VH. Transfusion of fresh frozen plasma in critically ill surgical patients is associated with an increased risk of infection. Crit Care Med. 2008;36(4):1114-1118.
Vamvakas EC. Meta-analysis of clinical studies of the purpoted deleterious effects of “old” (versus “fresh”) red blood cells: are we at equipoise? Transfusion. 2010;50:600-611.
Brunskill SJ, Wilkinson KL, Doree C, Trivella M, Stanworth S. Transfusion of fresher versus older red blood cells for all conditions. Cochrane Database Syst Rev. 2015;(5):CD010801.
Alexander PE, Barty R, Fei Y, Vandvik PO, Pai M, Siemieniuk RA, et al. Transfusion of fresher vs. older red blood cells in hospitalized patients: a systematic review and meta analysis. Blood. 2016;127(4):400-410.
Juffermans Np, Prins Dj, Vlaar AP, Nieuwland R, Binnekade JM. Transfusion-related risk of secondary bacterial infections in sepsis patients: a retrospective cohorte study. Shock. 2011;35(4):355-359.
Prestia K, Bandyopadhyay S, Slate A, Francis R, Spitalnik S, Fidock D, et al. Transfusion of stored blood impairs host defenses against Gram-negative pathogens in mice. Transfusion. 2014;54(11):2842-2851.
Tom KA, Jackson SS, Johnson JK, Srinivasan A, Magder L, Roghmann M, et al. Factors leading to transmission risk of Acinetobacter baumanii. Crit Care Med. 2015;45(7):e633-e639.
Ulu-Kilic A, Ahmed S, Moğanay M. Challenge of intensive care unit-adquired infections and Acinetobacter baumannii in developing countries. Critical Care Medicine & Pain. 2013;1(1):2.
Rosenthal V, Maki D, Graves N. The International Nosocomial Infection Control Consortium (INICC): goals and objectives, description of surveillance methods, and operational activities. Am J Infect Control. 2008;9(36):e1-12.
Alp E, Kiran B, Altun D, Kalin G, Coskun R, Sungur M, et al. Changing pattern of antibiotic susceptibility in intensive care units: ten years experience of a university hospital. Anaerobe. 2011;17(6):422-425.
Dupuis C, Sonneville R, Adrie CH, Gros A, Darmon M, Bouadma L, et al. Impact of transfusion on patients with sepsis admitted in intensive care unit: a systematic review and metaanalysis. Ann Intensive Care. 2017;7(5):1-13.
Simonetti A, Ezzeldin H, Menis M, McKean S, Izurieta H, Anderson S, Forshee R. Modeling the potential impact on the US blood supply of transfusing critically ill patients with fresher stored red blood cells. PLoS One. 2017;12(3): e0174033.
>Year 2018, Issue 3