Analysis of Risk Factors for Ventilator-Associated Pneumonia in a Multidisciplinary Intensive Care Unit

Sofianou, Danai; Constandinidis, T. C.; Yannacou, M.; Anastasiou, H.; Sofianos, E.

doi:10.1007/s100960000236

Cited by 62 publications

(35 citation statements)

References 11 publications

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“…aeruginosa , respectively. Similar observations were made by other investigators that reported 96-100% resistance;[1112] whereas, other workers have reported lower rate of resistance (37-67.5%) to ceftazidime. [1113] High rate of resistance at our center might be due to the selective influence of extensive usage of third generation cephalosporins.…”

Section: Discussionsupporting

confidence: 89%

Antibiotic sensitivity pattern of gram negative bacilli isolated from the lower respiratory tract of ventilated patients in the intensive care unit

Goel

Chaudhary

Aggarwal

et al. 2009

Indian Journal of Critical Care Medicine

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Background:Lower respiratory tract infections (LRTIs) are the most frequent infections among patients in Intensive care units (ICUs).Aims:To know the bacterial profile and determine the antibiotic susceptibility pattern of the lower respiratory tract isolates from patients admitted to the ICU.Settings and Design:Tertiary care hospital, retrospective study.Materials and Methods:Transtracheal or bronchial aspirates from 207 patients admitted to the ICU were cultured, identified, and antibiotic sensitivity was performed by standard methods.Statistical Analysis Used:SPSS software was used for calculation of % R of 95% confidence interval (CI).Results:Of 207 specimens, 144 (69.5%) were culture positive and 63 (30.4%) showed no growth. From 144 culture positives, 161 isolates were recovered, of which 154 (95.6%) were Gram negative bacilli (GNB). In 17 (11.0%) patients, two isolates per specimen were recovered. The most common GNB in order of frequency were Pseudomonas aeruginosa (35%), Acinetobacter baumannii (23.6%), and Klebsiella pneumoniae (13.6%). A very high rate of resistance (80-100%) was observed among predominant GNB to ciprofloxacin, ceftazidime, co-trimoxazole, and amoxycillin/clavulanic acid combination. Least resistance was noted to meropenem and doxycycline.Conclusion:Nonfermenters are the most common etiological agents of LRTIs in ICU. There is an alarmingly high rate of resistance to cephalosporin and β-lactam-β-lactamase inhibitor group of drugs. Meropenem was found to be the most sensitive drug against all GNB. Acinetobacter and Klebsiella spp. showed good sensitivity to doxycycline.

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Section: Discussionsupporting

confidence: 89%

Antibiotic sensitivity pattern of gram negative bacilli isolated from the lower respiratory tract of ventilated patients in the intensive care unit

Goel

Chaudhary

Aggarwal

et al. 2009

Indian Journal of Critical Care Medicine

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“…Garnacho-Montero et al [96] and Sofianou et al [98] suggested that VAP due to A. baumannii was not associated with a poorer prognosis than other causes of VAP, whereas Weingarten et al [99] suggested that the severity of the illness itself is the major determinant of mortality. In addition, the reported results from the SCOPE project, a prospective study with 49 participating hospitals in the USA, showed that the mortality of 111 patients with A. baumannii bloodstream infections was not significantly different from that of 2952 patients with bacteraemias caused by other Gram-negative organisms [90].…”

Section: The Clinical Impact Of Acinetobacter Infectionsmentioning

confidence: 97%

Acinetobacter baumannii: a universal threat to public health?

Giamarellou

Antoniadou

Kanellakopoulou

2008

International Journal of Antimicrobial Agents

198

136

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“…was responsible for 35% of ventilator associated pneumonia (VAP), making it the most conspicuous and dominant pathogen amongst all other bacteria encountered in that study. 17 However, only few case-control studies have identified and systematically reported the various risk factors associated with Acinetobacter infection or colonization. 5,7 Potential risk factors for Acinetobacter infection in many studies were prior surgery or prior use of broad-spectrum antibiotics.…”

Section: Discussionmentioning

confidence: 99%

Nosocomial infections due to Acinetobacter species: Clinical findings, risk and prognostic factors

Prashanth¹,

Badrinath²

2006

Indian J Med Microbiol

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Purpose: Nosocomial infections caused by Acinetobacter species is of increasing concern in critically ill patients, and the risk factors for this infection are not well established. The present investigation was done to determine incidence of nosocomial Acinetobacter infections. Our study retrospectively attempts to find risk and prognostic factors for the nosocomial acquisition of Acinetobacter infection. Methods: The medical records of 43 patients with Acinetobacter infection during two-year period (Oct1998-Oct2000) were reviewed to find the factors involved in the nosocomial acquisition of Acinetobacter. Acinetobacter isolates that were obtained from these patients were phenotypically typed using carbon assimilation tests. Antimicrobial susceptibility testing results were noted from the microbiology records. Results: Acinetobacter baumannii accounted for 41.8% (n=18) of all the infections. By multivariate logistic regression analysis, only resistant antibiotype {(Ceftazidime-OR, 7.13 [95% CI, 1 to 46]; P= 0.044); (Cefotaxime-OR, 6.09 [CI, 0.87 to 30]; P = 0.045)} and mechanical ventilation (OR, 5.84 [CI, 0.83 to 31]; P = 0.05) were found to be potential independent risk factors for mortality. Overall mortality rate was 33%. Conclusions: Most of A. baumannii isolates were multidrug resistant in our set up and infections due to them were associated with high mortality. Prevention of Multiple drug resistant (MDR) A. baumannii infections was achieved after discontinuation of cefotaxime in ICU. Infection with resistant clones and mechanical ventilation were found to be potential independent risk factors for mortality.

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Analysis of Risk Factors for Ventilator-Associated Pneumonia in a Multidisciplinary Intensive Care Unit

Cited by 62 publications

References 11 publications

Antibiotic sensitivity pattern of gram negative bacilli isolated from the lower respiratory tract of ventilated patients in the intensive care unit

Antibiotic sensitivity pattern of gram negative bacilli isolated from the lower respiratory tract of ventilated patients in the intensive care unit

Acinetobacter baumannii: a universal threat to public health?

Nosocomial infections due to Acinetobacter species: Clinical findings, risk and prognostic factors

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