O0054 Ventilator-associated pneumonia due to drug-resistant Acinetobacter baumannii: antibacterial resistance and independent predictors of in- mortality Ausra Ciginskiene*1,2, Greta Kasputyte3, Akvile Jurgelenaite4,3, Dalia Adukauskiene2,2

1 Lithuanian University of Health Sciences, , , 2 Department of Intensive Care, Hospital of Lithuanian University of Health Sciences Kaunas , Kaunas, Lithuania, 3 Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania, 4 Medical Academy, Lithuanian University of Health Sciences, Eivenių str.2, LT-50161 Kaunas, Lithuania , Kaunas, Lithuania Background: Drug resistance of A.baumanni strains, one of the most prevailing pathogen of ventilator-associated pneumonia (VAP), was steadily increasing across the Europe during recent years. The aim of this study was to identify drug-resistance profile, antibacterial resistance of A.baumannii strains as pathogen of ventilator- associated pneumonia (VAP), overall in-hospital mortality, and independent predictors of it. Materials/methods: A retrospective ongoing cohort study of 60 patients treated for VAP due to drug-resistant A.baumannii in medical-surgical ICUs over a 2-year period was carried out. Results: The proportions of multidrug-resistant, extensively drug-resistant (XDR), and potentially pandrug- resistant A.baumannii were 13.3%, 68.3%, and 18.3%, respectively. 60/60 (100%) strains of multidrug-resistant A.baumannii were resistant to piperacillin, piperacillin/tazobactam, and ciprofloxacin; 59/60 (98.3%) – to trimethoprim/sulfamethoxazole; 58/60 (96.7%) – to carbapenems, and ceftazidime; 57/60 (95%) – to cefepime; 51/60 (85%) – to ampicillin-sulbactam; 0/12 (0%) – to colistin. The overall in-hospital mortality rate was 63.3%. Univariate analysis revealed differences between survivors vs non-survivors in: means of SOFA score on ICU admission 9.41 (SD 4.33) vs 12.71 (SD 3.8), p=0.003, SAPS II score on ICU admission 41.73 (SD15.15) vs 51.55 (SD 10.14), p=0.011; in medians of transfused red blood cells units 0 (IQR 0-2.25) vs 2 (IQR 0-5), p=0.044, and in proportions of males 16/22 (51.6%) vs 15/38 (48.4%), p=0.017, females – 6/22 (20.7%) vs 23/38 (79.3%), p=0.017, presents of chronic diseases 12/22 (27.9%) vs 31/38 (72.1%), and red blood cells transfusion prior to VAP 9/22 (25%) vs 27/38 (75%), p=0.03. Binary logistic regression analysis showed that female gender (OR 5.26; CI: 1.21–22.83), SOFA score on ICU admission (OR 1.28; CI: 1.06–1.53), and red blood cells transfusion (OR 5.98; CI: 1.41–25.27) were independent predictors of in-hospital mortality. Conclusions: XDR drug resistance profile was prevailing among A.baumannii strains. A.baumannii strains were found to be associated with high rate of antibacterial resistance, as well as overall in-hospital mortality. Female gender, SOFA score and red blood cells transfusion were found to be independent predictors of in-hospital mortality. Resume: presented information makes possible to predict mortality, to influence strategy of treatment, and to be able to decrease the higher costs of healthcare in this contingent of patients.

29TH ECCMID 13-16 APRIL 2019 AMSTERDAM, NETHERLANDS POWERED BY M-ANAGE.COM