Both early-onset and late-onset ventilator-associated pneumonia are caused mainly by potentially multiresistant bacteria.
In: Intensive Care Medicine, Jg. 31 (2005-11-01), Heft 11, S. 1488-1494
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Zugriff:
Objective: To compare the causative pathogens of early-onset and late-onset ventilator-associated pneumonia (VAP) diagnosed by bronchoalveolar lavage quantitative cultures. Most previous reports have been based on endotracheal aspirate cultures and gave uncertain findings. Design: Prospective evaluation of consecutive patients with clinical suspicion for VAP. Setting: Multidisciplinary intensive care unit of a university hospital. Patients and Participants: During a 3-year period 473 patients with clinical suspicion of VAP entered the study. Diagnosis of VAP was confirmed by cultures of bronchoalveolar lavage (> 10(4) cfu/ml) specimens in 408 patients. Interventions: Protected bronchoalveolar lavage samples were taken. Initial antibiotic therapy was modified upon bronchoalveolar lavage culture results. Measurements and Results: Among 408 patients 191 had early-onset (< 7 days mechanical ventilation) and 217 late-onset (> or = 7 days) VAP. Potentially multiresistant bacteria, mainly Pseudomonas aeruginosa and methicillin-resistant Staphylococcus aureus (MRSA), were the most commonly isolated pathogens in both types of VAP. No difference was noted in the contribution of potentially multiresistant pathogens (79% vs. 85%), P. aeruginosa (42% vs. 47%), or MRSA (33% vs. 30%) between early-onset and late-onset VAP. Initial antibiotic therapy was modified in 58% of early-onset VAP episodes and in 36% of late-onset VAP episodes. No difference in mortality was found between the two types of VAP. Conclusions: Both early-onset and late-onset VAP were mainly caused by potentially multiresistant bacteria, most commonly P. aeruginosa and MRSA. Antimicrobial agents against these pathogens should be prescribed empirically, at least in our institution. [ABSTRACT FROM AUTHOR]
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Both early-onset and late-onset ventilator-associated pneumonia are caused mainly by potentially multiresistant bacteria.
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Autor/in / Beteiligte Person: | Giantsou, Elpis ; Liratzopoulos, Nikolaos ; Efraimidou, Eleni ; Panopoulou, Maria ; Alepopoulou, Eleonora ; Kartali-Ktenidou, Sofia ; Minopoulos, George I. ; Zakynthinos, Spyros ; Manolas, Konstantinos I. |
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Zeitschrift: | Intensive Care Medicine, Jg. 31 (2005-11-01), Heft 11, S. 1488-1494 |
Veröffentlichung: | 2005 |
Medientyp: | academicJournal |
ISSN: | 0342-4642 (print) |
DOI: | 10.1007/s00134-005-2697-y |
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