More nutritional research needed to prevent and treat ...

5 downloads 78712 Views 258KB Size Report
Adobe Reader then please also highlight the appropriate place in the PDF file. ... of any artwork, please consult http://www.elsevier.com/artworkinstructions.
YJCRC-51331; No of Page 1 Journal of Critical Care xxx (2013) xxx–xxx

Contents lists available at ScienceDirect

Journal of Critical Care journal homepage: www.jccjournal.org.

1

Correspondence

2

More nutritional research needed to prevent and treat Acinetobacter infections

3 4

5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31

To the Editor: I read with interest your recent article by Turkoglu et al [1], which reports that among 201 critically ill hospitalized patients, Acinetobacter infections were significantly more common in vitamin D–deficient patients as compared with those with normal vitamin D levels (25% vs 10%; P = .012). This article also cited a number of important articles, which report that vitamin D deficiency is common in both the general and hospitalized populations and that vitamin D levels are associated with significantly higher rates of infection and mortality. Many hospitalized patients are deficient in many nutrients including vitamin D. A 2007 review of 110 published articles reported that 13% to 78% of all hospitalized patients had protein-calorie malnutrition [2]. Protein-calorie malnutrition ranged from 42% to 91% in elderly hospitalized patients [2]. Malnutrition is associated with higher rates of hospital-acquired infections in general. A French study of 630 hospitalized patients reported that hospital-acquired infections were 4.98 times as common in severely malnourished patients as compared with well-nourished patients (95% confidence interval, 4.6-6.4) [3]. Several articles have reported that low albumin and other indicators of malnutrition are associated with significantly higher mortality rates from Acinetobacter infection. A Taiwan study reported that low albumin levels (below 2.5 g/dL) were associated with significantly higher rates of mortality among hospitalized patients with antibiotic-resistant Acinetobacter baumannii (80% vs 28%; P = .0102) [4]. A second Taiwan study of 149 hospitalized patients with Acinetobacter baumannii infections reported that serum albumin

levels were significantly lower among mortality patients vs survivors (2.9 ± 0.5 vs 3.2 ± 0.5 g/dL; P = .005) [5]. Vitamin D and many other nutrients (such as water, protein, calories, omega-3 fats, vitamins A, B complex and C, zinc, iron, and copper) play a critical role in preventing and fighting off infections [6]. Much more research and clinical attention are needed to prevent and treat hospital-acquired infections of Acinetobacter and other pathogens. I hope the Journal of Critical Care will continue to publish articles that examine the relationships between nutrition and infection.

32 33 34 35 36 37 38 39 40 41 42

Luke Curtis MD, MS 43 Forest Hills, NY 11375 44 E-mail address: [email protected] 45 46

http://dx.doi.org/10.1016/j.jcrc.2013.09.010

47

References

48

[1] Turkoglu M, Aygencel G, Dizbay M, et al. Is Vitamin D deficiency associated with development of Acinetobacter baumannii infections in critically ill patients? J Crit Care 2013;28:735–40. [2] Kubrak C, Jensen L. Malnutrition in acute care patients: a narrative review. Int J Nurs Stud 2007;44:1036–54. [3] Schneider SM, Veyres P, Pivot X, et al. Malnutrition is an independent risk factor associated with nosocomial infections. Br J Nutr 2004;92:105–11. [4] Tseng YC, Wang JT, Wu FLL, et al. Prognosis of adult patients with bacteremia caused by extensively resistant Acinetobacter baumannii. Diagn Microbiol Infect Dis 2007;59:181–90. [5] Chen HP, Chen TL, Lai CH, et al. Predictors of mortality in Acinetobacter baumanni bacteriemia. J Microbiol Immunol Infect 2005;38:127–36. [6] Wintergerst ES, Maggini R, Hornig DH. Contribution of selected vitamins and trace elements to immune function. Ann Nutr Metab 2007;51:301–23.

49 50 51 52 53 54 55 56 57 58 59 60 61 62 63

64

0883-9441/$ – see front matter © 2013 Published by Elsevier Inc.

Please cite this article as: Curtis L, More nutritional research needed to prevent and treat Acinetobacter infections, J Crit Care (2013), http:// dx.doi.org/10.1016/j.jcrc.2013.09.010

Our reference: YJCRC 51331

P-authorquery-v11

AUTHOR QUERY FORM Journal: YJCRC

Please e-mail or fax your responses and any corrections to: Elsevier E-mail: [email protected] Fax: +1 619 699 6721

Article Number: 51331 Dear Author, Please check your proof carefully and mark all corrections at the appropriate place in the proof (e.g., by using on-screen annotation in the PDF file) or compile them in a separate list. Note: if you opt to annotate the file with software other than Adobe Reader then please also highlight the appropriate place in the PDF file. To ensure fast publication of your paper please return your corrections within 48 hours. For correction or revision of any artwork, please consult http://www.elsevier.com/artworkinstructions.

No queries have arisen during the processing of your article.

Thank you for your assistance.

Page 1 of 1