Table 1.

Variables	Overall, n = 497	Acinetobacter baumannii isolated		p value	Hazard ratio (95% CI)
Variables	Overall, n = 497	Yes, n = 159	No, n = 338	p value	Hazard ratio (95% CI)
Median age, y (IQR)	60.1 (49–73)	61 (50–74)	59.6 (49–73)	0.444	1.004 (0.994–1.013)
Sex, no. (%)
F	160 (32.2)	44 (27.7)	116 (34.3)	Referent
M	337 (67.8)	115 (72.3)	222 (65.7)	0.139	0.769 (0.544–1.089)
Mean Charlson comorbidity index, (SD)	4.26 (2.12)	4.40 (2.14)	4.20 (2.11)	0.293	1.038 (0.968–1.113)
Underlying conditions, no. (%)
Cardiovascular diseases	200 (40.2)	79 (49.7)	121 (358)	0.003	1.596 (1.169–2.178)
Chronic renal insufficiency	179 (36.0)	71 (44.7)	108 (32.0)	0.011	1.504 (1.200–2.056)
COPD and asthma	176 (35.4)	71 (44.7)	105 (31.1)	0.005	1.570 (1.148–2.146)
Type 2 diabetes mellitus	116 (23.3)	46 (28.9)	70 (20.7)	0.057	1.395 (0.990–1.965)
Solid tumor	100 (20.1)	36 (22.6)	64 (18.9)	0.363	1.188 (0.820–1.723)
Hematologic malignancy	31 (6.2)	8 (5.0)	23 (6.8)	0.497	0.781 (0.384–1.591)
Past inhaled steroids use for chronic conditions	47 (9.5)	17 (10.7)	30 (8.9)	0.450	1.214 (0.734–2.007)
Current or former smoker	187 (37.6)	74 (46.5)	113 (33.4)	0.005	1.565 (1.146–2.138)
Postoperative admission	142 (28.6)	38 (23.9)	104 (30.8)	0.134	0.757 (0.526–1.090)
Treatment, no. (%)
No aerosol inhalation	137 (27.6)	33 (20.8)	104 (30.8)	Referent
Glucocorticoid aerosol inhalation	262 (52.7)	107 (67.3)	155 (45.9)	0.002	1.860 (1.264–2.738)
Aerosol inhalation without glucocorticoid	98 (19.7)	19 (11.9)	79 (23.4)	0.337	0.760 (0.433–1.332)
Broad-spectrum antimicrobial drugs, ≥7 d	417 (83.9)	157 (98.7)	260 (76.9)	<0.001	9.539 (4.595–18.795)
Invasive mechanical ventilation, ≥5 d	221 (44.5)	112 (70.4)	109 (32.2)	<0.001	3.452 (2.453–4.858)
Urethral catheter placement, ≥3 d	493 (99.2)	158 (99.4)	335 (99.1)	0.875	1.171 (0.164–8.361)
Vasopressor treatment, ≥3 d	75 (15.1)	42 (26.4)	33 (9.8)	<0.001	2.634 (1.850–3.750)
Renal dialysis, ≥3 d	84 (16.9)	34 (21.4)	50 (14.8)	0.063	1.432 (0.980–2.093)
APACHE II score, mean (SD)	18.18 (6.03)	18.98 (6.44)	17.80 (5.80)	0.053	1.026 (1.000–1.053)
Median length of ICU stay, d (IQR)	15 (7–23)	20 (10–28)	13 (6–20)	0.057	1.005 (1.000–1.010)

Table 1. Univariate analysis of risk factors for Acinetobacter baumannii among patients during invasive mechanical ventilation, China*

*APACHE II, Acute Physiology and Chronic Health Evaluation II; COPD, chronic obstructive pulmonary disease; ICU, intensive care unit; IQR, interquartile range.

Table 2.

Variables	p value	Hazard ratio (95% CI)
Underlying conditions
Cardiovascular diseases	0.054	1.394 (0.994–1.955)
Chronic renal insufficiency	0.730	0.937 (0.648–1.356)
COPD and asthma	0.132	1.299 (0.924–1.825)
Type 2 diabetes mellitus	0.325	1.197 (0.837–1.714)
Current or former smoker	0.098	1.307 (0.951–1.797)
Treatment
No aerosol inhalation	Referent
Glucocorticoid aerosol inhalation	0.038	1.528 (1.024–2.278)
Aerosol inhalation without glucocorticoid	0.524	0.829 (0.467–1.475)
Broad-spectrum antimicrobial drugs, ≥7 d	0.001	7.238 (2.758–15.788)
Invasive mechanical ventilation, ≥5 d	0.001	2.381 (1.664–3.405)
Vasopressor treatment, ≥3 d	<0.001	2.060 (1.402–3.028)
Renal dialysis, ≥3 d	0.841	1.046 (0.675–1.620)
APACHE II score	0.586	0.992 (0.965–1.020)

Table 2. Multivariate analysis of risk factors for Acinetobacter baumannii among patients during invasive mechanical ventilation, China*

*Results are from model 2; only variables with p<0.1 in univariate analysis were included. APACHE II, Acute Physiology and Chronic Health Evaluation II; COPD, chronic obstructive pulmonary disease.

Table 3.

Variables	p value	Hazard ratio (95% CI)
Underlying conditions
Cardiovascular diseases	0.117	1.361 (0.926–2.001)
Chronic renal insufficiency	0.800	1.052 (0.712–1.554)
Type 2 diabetes mellitus	0.243	1.271 (0.850–1.899)
Current or former smoker	0.051	1.442 (0.998–2.083)
Treatment
Glucocorticoid aerosol inhalation	0.032	1.489 (1.036–2.141)
Broad-spectrum antimicrobial drugs, ≥7 d	0.004	6.315 (2.543–13.921)
Invasive mechanical ventilation, ≥5 d	<0.001	2.388 (1.614–3.534)
Vasopressor treatment, ≥3 d	0.501	1.188 (0.719–1.963)
APACHE II score	0.363	1.014 (0.984–1.045)

Table 3. Multivariate analysis of risk factors for Acinetobacter baumannii among propensity-matched patient cohort during invasive mechanical ventilation, China*

*Only variables with p<0.1 in univariate analysis of the propensity-matched cohort were included. APACHE II, Acute Physiology and Chronic Health Evaluation II; COPD, chronic obstructive pulmonary disease.

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Faculty

Wenchao Zhang, MD, PhD

Qilu Hospital of Shandong University
Jinan, China

Mei Yin, MD, PhD

Qilu Hospital of Shandong University
Jinan, China

Wei Li, MD, PhD

Qilu Hospital of Shandong University
Jinan, China

Nana Xu, MD

Qilu Hospital of Shandong University
Jinan, China

Haining Lu, MD

Qingdao Branch Qilu Hospital of Shandong University Qingdao, China

Weidong Qin, MD, PhD

Qilu Hospital of Shandong University
Jinan, China

Hui Han, MD

Qilu Hospital of Shandong University
Jinan, China

Chen Li, MD

Qilu Hospital of Shandong University
Jinan, China

Dawei Wu, MD

Qingdao Branch
Qilu Hospital of Shandong University
Qingdao, China

Hao Wang, MD, PhD

Qilu Hospital of Shandong University
Jinan, China

CME Author

Charles P. Vega, MD

Health Sciences Clinical Professor of Family Medicine
University of California, Irvine School of Medicine

Disclosures

Charles P. Vega, MD, has the following relevant financial relationships:
Consultant or advisor for: GlaxoSmithKline; Johnson & Johnson Pharmaceutical Research & Development, L.L.C.

Editor

Amy J. Guinn, BA, MA

Copyeditor
Emerging Infectious Diseases

Compliance Reviewer

Amanda Jett, PharmD, BCACP

Associate Director, Accreditation and Compliance, Medscape, LLC

Disclosures

Amanda Jett, PharmD, BCACP, has no relevant financial relationships.

CME / ABIM MOC

Acinetobacter baumannii Among Patients Receiving Glucocorticoid Aerosol Therapy During Invasive Mechanical Ventilation, China

Authors: Wenchao Zhang, MD, PhD; Mei Yin, MD, PhD; Wei Li, MD, PhD; Nana Xu, MD; Haining Lu, MD; Weidong Qin, MD, PhD; Hui Han, MD; Chen Li, MD; Dawei Wu, MD; Hao Wang, MD, PhD
CME / ABIM MOC Released: 11/17/2022
THIS ACTIVITY HAS EXPIRED FOR CREDIT
Valid for credit through: 11/17/2023, 11:59 PM EST

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Target Audience and Goal Statement

This activity is intended for primary care physicians, infectious disease specialists, critical care specialists, and other physicians who care for patients receiving invasive mechanical ventilation (IMV).

The goal of this activity is for learners to be better able to discuss how aerosol treatments may affect the risk for infection with Acinetobacter baumannii (AB).

Upon completion of this activity, participants will:

Distinguish the percentage of patients receiving invasive mechanical ventilation (IMV) who had a positive culture for Acinetobacter baumannii (AB)
Assess the role of aerosol inhalation in the isolation of AB in the current study
Analyze risk factors for the isolation of AB in the current study
Evaluate the effects of aerosol inhalation and AB on the risk for mortality among patients receiving IMV

Disclosures

Faculty

Wenchao Zhang, MD, PhD

Qilu Hospital of Shandong University
Jinan, China

Mei Yin, MD, PhD

Qilu Hospital of Shandong University
Jinan, China

Wei Li, MD, PhD

Qilu Hospital of Shandong University
Jinan, China

Nana Xu, MD

Qilu Hospital of Shandong University
Jinan, China

Haining Lu, MD

Qingdao Branch Qilu Hospital of Shandong University Qingdao, China

Weidong Qin, MD, PhD

Qilu Hospital of Shandong University
Jinan, China

Hui Han, MD

Qilu Hospital of Shandong University
Jinan, China

Chen Li, MD

Qilu Hospital of Shandong University
Jinan, China

Dawei Wu, MD

Qingdao Branch
Qilu Hospital of Shandong University
Qingdao, China

Hao Wang, MD, PhD

Qilu Hospital of Shandong University
Jinan, China

CME Author

Charles P. Vega, MD

Health Sciences Clinical Professor of Family Medicine
University of California, Irvine School of Medicine

Disclosures

Charles P. Vega, MD, has the following relevant financial relationships:
Consultant or advisor for: GlaxoSmithKline; Johnson & Johnson Pharmaceutical Research & Development, L.L.C.

Editor

Amy J. Guinn, BA, MA

Copyeditor
Emerging Infectious Diseases

Compliance Reviewer

Amanda Jett, PharmD, BCACP

Associate Director, Accreditation and Compliance, Medscape, LLC

Disclosures

Amanda Jett, PharmD, BCACP, has no relevant financial relationships.

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From Emerging Infectious Diseases

CME / ABIM MOC

Acinetobacter baumannii Among Patients Receiving Glucocorticoid Aerosol Therapy During Invasive Mechanical Ventilation, China

Authors: Wenchao Zhang, MD, PhD; Mei Yin, MD, PhD; Wei Li, MD, PhD; Nana Xu, MD; Haining Lu, MD; Weidong Qin, MD, PhD; Hui Han, MD; Chen Li, MD; Dawei Wu, MD; Hao Wang, MD, PhDFaculty and Disclosures

THIS ACTIVITY HAS EXPIRED FOR CREDIT

CME / ABIM MOC Released: 11/17/2022

Valid for credit through: 11/17/2023, 11:59 PM EST

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References

Vincent JL, Rello J, Marshall J, Silva E, Anzueto A, Martin CD, et al.; EPIC II Group of Investigators. International study of the prevalence and outcomes of infection in intensive care units. JAMA. 2009;302:2323–9.
Vincent JL, Sakr Y, Singer M, Martin-Loeches I, Machado FR, Marshall JC, et al.; EPIC III Investigators. Prevalence and outcomes of infection among patients in intensive care units in 2017. JAMA. 2020;323:1478–87.
Mea HJ, Yong PVC, Wong EH. An overview of Acinetobacter baumannii pathogenesis: Motility, adherence and biofilm formation. Microbiol Res. 2021;247:126722.
Lynch JP III, Zhanel GG, Clark NM. Infections due to Acinetobacter baumannii in the ICU: treatment options. Semin Respir Crit Care Med. 2017;38:311–25.
Shi J, Sun T, Cui Y, Wang C, Wang F, Zhou Y, et al. Multidrug resistant and extensively drug resistant Acinetobacter baumannii hospital infection associated with high mortality: a retrospective study in the pediatric intensive care unit. BMC Infect Dis. 2020;20:597.
Sunenshine RH, Wright MO, Maragakis LL, Harris AD, Song X, Hebden J, et al. Multidrug-resistant Acinetobacter infection mortality rate and length of hospitalization. Emerg Infect Dis. 2007;13:97–103.
Blanco N, Harris AD, Rock C, Johnson JK, Pineles L, Bonomo RA, et al.; the CDC Epicenters Program. Risk factors and outcomes associated with multidrug-resistant Acinetobacter baumannii upon intensive care unit admission. Antimicrob Agents Chemother. 2017;62:e01631–17.
Zhang C, Mi J, Wang X, Lv S, Zhang Z, Nie Z, et al. Knowledge and current practices of ICU nurses regarding aerosol therapy for patients treated with invasive mechanical ventilation: A nationwide cross-sectional study. J Clin Nurs. 2021;30:3429–38.
Zhang Z, Xu P, Fang Q, Ma P, Lin H, Fink JB, et al.; China Union of Respiratory Care (CURC). Practice pattern of aerosol therapy among patients undergoing mechanical ventilation in mainland China: A web-based survey involving 447 hospitals. PLoS One. 2019;14:e0221577.
Lyu S, Li J, Wu M, He D, Fu T, Ni F, et al.; Respiratory Care Committee in Chinese Thoracic Society. The use of aerosolized medications in adult intensive care unit patients: A prospective, multicenter, observational, cohort Study. J Aerosol Med Pulm Drug Deliv. 2021;34:383–91.
Lyu S, Li J, Yang L, Du X, Liu X, Chuan L, et al. The utilization of aerosol therapy in mechanical ventilation patients: a prospective multicenter observational cohort study and a review of the current evidence. Ann Transl Med. 2020;8:1071.
Dhand R. Inhaled drug therapy 2016: the year in review. Respir Care. 2017;62:978–96.
Ari A. Practical strategies for a safe and effective delivery of aerosolized medications to patients with COVID-19. Respir Med. 2020;167:105987.
Singanayagam A, Glanville N, Cuthbertson L, Bartlett NW, Finney LJ, Turek E, et al. Inhaled corticosteroid suppression of cathelicidin drives dysbiosis and bacterial infection in chronic obstructive pulmonary disease. Sci Transl Med. 2019;11:eaav3879.
Ernst P, Gonzalez AV, Brassard P, Suissa S. Inhaled corticosteroid use in chronic obstructive pulmonary disease and the risk of hospitalization for pneumonia. Am J Respir Crit Care Med. 2007;176:162–6.
Sibila O, Soto-Gomez N, Restrepo MI. The risk and outcomes of pneumonia in patients on inhaled corticosteroids. Pulm Pharmacol Ther. 2015;32:130–6.
Artigas A, Camprubí-Rimblas M, Tantinyà N, Bringué J, Guillamat-Prats R, Matthay MA. Inhalation therapies in acute respiratory distress syndrome. Ann Transl Med. 2017;5:293.
van Rensen EL, Straathof KC, Veselic-Charvat MA, Zwinderman AH, Bel EH, Sterk PJ. Effect of inhaled steroids on airway hyperresponsiveness, sputum eosinophils, and exhaled nitric oxide levels in patients with asthma. Thorax. 1999;54:403–8.
Horvath G, Wanner A. Inhaled corticosteroids: effects on the airway vasculature in bronchial asthma. Eur Respir J. 2006;27:172–87.
Leading Industry Research Network. Analysis on market demand status and market development trend of budesonide inhalation preparations in China in 2020. 2020 Nov 23 [cited 2022 Jan 24]. http://www.leadingir.com/datacenter/view/5683.html
Gales AC, Seifert H, Gur D, Castanheira M, Jones RN, Sader HS. Antimicrobial susceptibility of Acinetobacter calcoaceticus-Acinetobacter baumannii complex and Stenotrophomonas maltophilia clinical isolates: results from the SENTRY antimicrobial surveillance program (1997–2016). Open Forum Infect Dis. 2019;6(Suppl 1):S34–46.
European Centre for Disease Prevention and Control. Surveillance of antimicrobial resistance in Europe 2018. Stockholm: The Centre; 2019.
Hu F, Guo Y, Zhu D, Wang F, Jiang X, Xu Y, et al. CHINET surveillance of bacterial resistance in China: 2018 report. Chin J Infect Chemother. 2020;20:1–10.
Wang F, Zhu D, Hu F, Jiang X, Hu Z, Li Q, et al. 2012 CHINET surveillance of bacterial resistance in China. Chin J Infect Chemother. 2013;13:321–30.
Meng X, Fu J, Zheng Y, Qin W, Yang H, Cao D, et al. Ten-year changes in bloodstream infection with Acinetobacter baumannii complex in intensive care units in eastern China: a retrospective cohort study. Front Med (Lausanne). 2021;8:715213.
Chung DR, Song JH, Kim SH, Thamlikitkul V, Huang SG, Wang H, et al.; Asian Network for Surveillance of Resistant Pathogens Study Group. High prevalence of multidrug-resistant nonfermenters in hospital-acquired pneumonia in Asia. Am J Respir Crit Care Med. 2011;184:1409–17.
Xie J, Yang Y, Huang Y, Kang Y, Xu Y, Ma X, et al. The current epidemiological landscape of ventilator-associated pneumonia in the intensive care unit: a multicenter prospective observational study in China. Clin Infect Dis. 2018;67(suppl_2):S153–61.
Hu FP, Guo Y, Zhu DM, Wang F, Jiang XF, Xu YC, et al. Resistance trends among clinical isolates in China reported from CHINET surveillance of bacterial resistance, 2005-2014. Clin Microbiol Infect. 2016;22(Suppl 1):S9–14.
Hu F, Guo Y, Yang Y, Zheng Y, Wu S, Jiang X, et al.; China Antimicrobial Surveillance Network (CHINET) Study Group. Resistance reported from China antimicrobial surveillance network (CHINET) in 2018. Eur J Clin Microbiol Infect Dis. 2019;38:2275–81.
Huang H, Chen B, Liu G, Ran J, Lian X, Huang X, et al. A multi-center study on the risk factors of infection caused by multi-drug resistant Acinetobacter baumannii. BMC Infect Dis. 2018;18:11.
Bassetti M, Righi E, Vena A, Graziano E, Russo A, Peghin M. Risk stratification and treatment of ICU-acquired pneumonia caused by multidrug- resistant/extensively drug-resistant/pandrug-resistant bacteria. Curr Opin Crit Care. 2018;24:385–93.
Freire MP, de Oliveira Garcia D, Garcia CP, Campagnari Bueno MF, Camargo CH, Kono Magri ASG, et al. Bloodstream infection caused by extensively drug-resistant Acinetobacter baumannii in cancer patients: high mortality associated with delayed treatment rather than with the degree of neutropenia. Clin Microbiol Infect. 2016;22:352–8.
Yamada K, Yanagihara K, Araki N, Harada Y, Morinaga Y, Akamatsu N, et al. Clinical characteristics of tertiary hospital patients from whom Acinetobacter calcoaceticus-Acinetobacter baumannii complex strains were isolated. Intern Med. 2012;51:51–7.
Jang TN, Lee SH, Huang CH, Lee CL, Chen WY. Risk factors and impact of nosocomial Acinetobacter baumannii bloodstream infections in the adult intensive care unit: a case-control study. J Hosp Infect. 2009;73:143–50.
Mor A, Thomsen RW, Ulrichsen SP, Sørensen HT. Chronic heart failure and risk of hospitalization with pneumonia: a population-based study. Eur J Intern Med. 2013;24:349–53.
Ehrmann S, Roche-Campo F, Sferrazza Papa GF, Isabey D, Brochard L, Apiou-Sbirlea G; REVA research network. Aerosol therapy during mechanical ventilation: an international survey. Intensive Care Med. 2013;39:1048–56.
Hashemian SM, Mortaz E, Jamaati H, Bagheri L, Mohajerani SA, Garssen J, et al. Budesonide facilitates weaning from mechanical ventilation in difficult-to-wean very severe COPD patients: Association with inflammatory mediators and cells. J Crit Care. 2018;44:161–7.
Ju YN, Yu KJ, Wang GN. Budesonide ameliorates lung injury induced by large volume ventilation. BMC Pulm Med. 2016;16:90.
Yang M, Zhang Y, Chen H, Lin J, Zeng J, Xu Z. Inhaled corticosteroids and risk of upper respiratory tract infection in patients with asthma: a meta-analysis. Infection. 2019;47:377–85.
Yang M, Chen H, Zhang Y, Du Y, Xu Y, Jiang P, et al. Long-term use of inhaled corticosteroids and risk of upper respiratory tract infection in chronic obstructive pulmonary disease: a meta-analysis. Inhal Toxicol. 2017;29:219–26.
McKeever T, Harrison TW, Hubbard R, Shaw D. Inhaled corticosteroids and the risk of pneumonia in people with asthma: a case-control study. Chest. 2013;144:1788–94.
Wang J, Li F, Tian Z. Role of microbiota on lung homeostasis and diseases. Sci China Life Sci. 2017;60:1407–15.
Sze MA, Dimitriu PA, Hayashi S, Elliott WM, McDonough JE, Gosselink JV, et al. The lung tissue microbiome in chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2012;185:1073–80.
Hilty M, Burke C, Pedro H, Cardenas P, Bush A, Bossley C, et al. Disordered microbial communities in asthmatic airways. PLoS One. 2010;5:e8578.
Laroumagne S, Lepage B, Hermant C, Plat G, Phelippeau M, Bigay-Game L, et al. Bronchial colonisation in patients with lung cancer: a prospective study. Eur Respir J. 2013;42:220–9.
Dickson RP, Singer BH, Newstead MW, Falkowski NR, Erb-Downward JR, Standiford TJ, et al. Enrichment of the lung microbiome with gut bacteria in sepsis and the acute respiratory distress syndrome. Nat Microbiol. 2016;1:16113.
Dickson RP, Erb-Downward JR, Huffnagle GB. Towards an ecology of the lung: new conceptual models of pulmonary microbiology and pneumonia pathogenesis. Lancet Respir Med. 2014;2:238–46.
Lai Y, Gallo RL. AMPed up immunity: how antimicrobial peptides have multiple roles in immune defense. Trends Immunol. 2009;30:131–41.
Ramsheh MY, Haldar K, Esteve-Codina A, Purser LF, Richardson M, Müller-Quernheim J, et al. Lung microbiome composition and bronchial epithelial gene expression in patients with COPD versus healthy individuals: a bacterial 16S rRNA gene sequencing and host transcriptomic analysis. Lancet Microbe. 2021;2:e300–10.
Huang C, Yu Y, Du W, Liu Y, Dai R, Tang W, et al. Fungal and bacterial microbiome dysbiosis and imbalance of trans-kingdom network in asthma. Clin Transl Allergy. 2020;10:42.

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CME / ABIM MOC Information

References

Table 1.

Table 2.

Table 3.

Faculty and Disclosures

Faculty

Wenchao Zhang, MD, PhD

Mei Yin, MD, PhD

Wei Li, MD, PhD

Nana Xu, MD

Haining Lu, MD

Weidong Qin, MD, PhD

Hui Han, MD

Chen Li, MD

Dawei Wu, MD

Hao Wang, MD, PhD

CME Author

Charles P. Vega, MD

Editor

Amy J. Guinn, BA, MA

Compliance Reviewer

Amanda Jett, PharmD, BCACP

CME / ABIM MOC

Acinetobacter baumannii Among Patients Receiving Glucocorticoid Aerosol Therapy During Invasive Mechanical Ventilation, China

Target Audience and Goal Statement

Disclosures

Faculty

Wenchao Zhang, MD, PhD

Mei Yin, MD, PhD

Wei Li, MD, PhD

Nana Xu, MD

Haining Lu, MD

Weidong Qin, MD, PhD

Hui Han, MD

Chen Li, MD

Dawei Wu, MD

Hao Wang, MD, PhD

CME Author

Charles P. Vega, MD

Editor

Amy J. Guinn, BA, MA

Compliance Reviewer

Amanda Jett, PharmD, BCACP

Accreditation Statements

For Physicians

Instructions for Participation and Credit

Acinetobacter baumannii Among Patients Receiving Glucocorticoid Aerosol Therapy During Invasive Mechanical Ventilation, China

References

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