Vitamin D level is associated with mortality predictors in ventilator-associated pneumonia caused by Acinetobacter baumannii

  • Murat Haliloglu Marmara University School of Medicine, Istanbul, Turkey
  • Beliz Bilgili Marmara University School of Medicine, Istanbul, Turkey
  • Ozlem Haliloglu Istanbul University Cerrahpasa Medical Faculty, Istanbul, Turkey
  • Dilek Gogas Yavuz Marmara University School of Medicine, Istanbul, Turkey
  • Ismail Cinel Marmara University School of Medicine, Istanbul, Turkey
Keywords: vitamin D deficiency, nutrition, ventilator-associated pneumonia, infection, Acinetobacter baumanii, mortality

Abstract

Introduction: Vitamin D plays a role in host defense and is known to be associated with mortality in patients in the intensive care unit (ICU). We aimed to evaluate the relationships between vitamin D levels and predictors of mortality in patients with ventilator-associated pneumonia (VAP) caused by extensively drug-resistant Acinetobacter baumanii (XDR A. baumanii).

Methodology: A retrospective single-center study was conducted in an 18-bed adult ICU of a teaching hospital, including all patients with VAP due to XDR A. baumanii. Levels of 25(OH)D, procalcitonin (PCT), C-reactive protein (CRP), n-terminal pro-BNP (NT-proBNP), as well as clinical scores (Sequential Organ Failure Assessment [SOFA], Acute Physiology And Chronic Health Evaluation [APACHE II], Clinical Pulmonary Infection Score [CPIS) were recorded.

Results: Forty-for patients were studied over six months. All patients had vitamin D deficiency. The 28-day mortality in patients with 25(OH)D levels ≤ 10 ng/mL was higher than in patients with 25(OH)D > 10ng/mL (p = 0.001). The fourth- and seventh-day SOFA scores (p= 0.04 and p= 0.001) and first- and fourth-day procalcitonin levels (p = 0.03 and p = 0.004) were higher in patients with 25(OH)D levels ≤ 10 ng/mL. The clinical scores (SOFA, CPIS, and CEPPIS) and biomarkers (NT-proBNP, PCT) were negatively correlated with 25(OH)D levels in all study groups.

Conclusions: Severe vitamin D deficiency was associated with adverse outcome in VAP due to XDR A. baumanii. Vitamin D levels may be a prognostic predictor of VAP. It is also important to evaluate the effect of rapid vitamin D replacement on mortality.

Author Biographies

Murat Haliloglu, Marmara University School of Medicine, Istanbul, Turkey
Department of Anesthesiology and Reanimation
Beliz Bilgili, Marmara University School of Medicine, Istanbul, Turkey
Department of Anesthesiology and Reanimation
Ozlem Haliloglu, Istanbul University Cerrahpasa Medical Faculty, Istanbul, Turkey
Department of Endocrinology and Metabolism
Dilek Gogas Yavuz, Marmara University School of Medicine, Istanbul, Turkey
Department of Endocrinology and Metabolism
Ismail Cinel, Marmara University School of Medicine, Istanbul, Turkey
Department of Anesthesiology and Reanimation
Published
2016-06-30
How to Cite
1.
Haliloglu M, Bilgili B, Haliloglu O, Gogas Yavuz D, Cinel I (2016) Vitamin D level is associated with mortality predictors in ventilator-associated pneumonia caused by Acinetobacter baumannii. J Infect Dev Ctries 10:567-574. doi: 10.3855/jidc.8206
Section
Original Articles