Initial Bacterial Colonization in Patients Admitted to a Respiratory Intensive Care Unit:Bacteriological Pattern and Risk Factors

Drakulović, Mitra; Bauer, Torsten T.; Torres, Antoni; González, Julià; Rodríguez, M. Cabello; Angrill, Joaquim

doi:10.1159/000050464

Cited by 39 publications

(30 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The role of anaerobes in the pathogenesis of pneumonia in hospitalized patients, especially in critically or chronically ill patients, is still controversial [4,15,16]. It is known that pneumonia is preceded by microbial colonization of the lower airways [17]. In our studies, heavy colonization of lower airways by anaerobic bacteria, mainly potentially pathogenic species, was found in the lung cancer group, comprising 73.3% of the patients.…”

mentioning

confidence: 55%

Anaerobic bacteria colonizing the lower airways in lung cancer patients

Rybojad¹,

Łoś²,

Sawicki³

et al. 2011

Folia Histochem Cytobiol.

View full text Add to dashboard Cite

Abstract:Abstract: Abstract: Abstract: Abstract: Anaerobes comprise most of the endogenous oropharyngeal microflora, and can cause infections of airways in lung cancer patients who are at high risk for respiratory tract infections. The aim of this study was to determine the frequency and species diversity of anaerobes in specimens from the lower airways of lung cancer patients. Sensitivity of the isolates to conventional antimicrobial agents used in anaerobe therapy was assessed. Respiratory secretions obtained by bronchoscopy from 30 lung cancer patients were cultured onto Wilkins--Chalgren agar in anaerobic conditions at 37°C for 72-96 hours. The isolates were identified using microtest Api 20A. The minimal inhibitory concentrations for penicillin G, amoxicillin/clavulanate, piperacillin/tazobactam, cefoxitin, imipenem, clindamycin, and metronidazole were determined by E-test. A total of 47 isolates of anaerobic bacteria were detected in 22 (73.3%) specimens. More than one species of anaerobe was found in 16 (53.3%) samples. The most frequently isolated were Actinomyces spp. and Peptostreptococcus spp., followed by Eubacterium lentum, Veillonella parvula, Prevotella spp., Bacteroides spp., Lactobacillus jensenii. Among antibiotics used in the study amoxicillin/clavulanate and imipenem were the most active in vitro (0% and 2% resistant strains, respectively). The highest resistance rate was found for penicillin G and metronidazole (36% and 38% resistant strains, respectively). The results obtained confirm the need to conduct analyses of anaerobic microflora colonizing the lower respiratory tract in patients with lung cancer to monitor potential etiologic factors of airways infections, as well as to propose efficient, empirical therapy. (Folia Histochemica et

show abstract

mentioning

confidence: 55%

Anaerobic bacteria colonizing the lower airways in lung cancer patients

Rybojad¹,

Łoś²,

Sawicki³

et al. 2011

Folia Histochem Cytobiol.

View full text Add to dashboard Cite

show abstract

“…Patients with COPD are prone to PMV because of impaired lung mechanics and respiratory muscle dysfunction. Additionally, structural abnormalities in their lungs, frequent association with bronchiectasis, repeated hospital admissions and use of antibiotics predispose these patients to colonization and infections with resistant microorganisms [17,18,19]. Due to all these reasons it was not surprising that VAP was an independent risk factor for MV >7 and >15 days in our study.…”

Section: Discussionmentioning

confidence: 76%

Determinants of the Length of Mechanical Ventilation in Patients with COPD in the Intensive Care Unit

Gürsel

2005

Respiration

View full text Add to dashboard Cite

Background: About 10% of the patients with chronic obstructive pulmonary disease (COPD) are at high risk for prolonged mechanical ventilation (MV >21 days), and mortality ranges from 55 to 78% in these patients. Objective: To determine the potential risk factors for MV over periods of 1, 2 and 3 weeks in patients with COPD. Patients and Method: The characteristics of patients during the stable period of their disease, on admission to the intensive care unit (ICU) and during the ICU stay were recorded prospectively and analyzed retrospectively for this study. t test, XXX² test and logistic regression analysis were used for statistical analysis. Results: 86 patients with COPD requiring MV were included in the study. 73, 33, and 13% of the patients required MV longer than 1, 2 and 3 weeks, respectively. There were no significant relationships between the duration of MV and bronchiectasis or the presence of community-acquired pneumonia on admission, baseline pulmonary function test results or blood gas parameters on admission. Development of ventilator-associated pneumonia (VAP; odds ratio, OR: 6; 95% confidence interval, CI: 2–23, p = 0.011) and sepsis (OR: 10; 95% CI: 2–54, p = 0.007) were independent predictors for MV >7 days. VAP was still a risk factor for MV >15 days with an OR of 14 (95% CI: 3–66, p = 0.001). On the other hand MV >21 days was primarily determined by increasing age (OR: 1.2; 95% CI: 1–1.3, p = 0.042), severity of the disease on admission measured by APACHE II score (OR: 1.4; 95% CI: 1–1.7, p = 0.002) and albumin levels (OR: 0.10, 95% CI: 0.01–0.54, p = 0.007). Conclusion: Advanced age, severity of disease on admission and development of VAP during ICU stay are the main determinants of MV duration in patients with COPD.

show abstract

“…This finding may be related to the previous hospitalization period (3¡1 days) in the present series, as the patients observed in CABELLO et al [7] were investigated before admission to the hospital. It is well known that prior hospitalization is a risk factor for abnormal colonization, at least in critically ill patients [14]. Further prospective studies would be required to confirm this hypothesis.…”

Section: Discussionmentioning

confidence: 92%

Bronchial bacterial colonization in patients with resectable lung carcinoma

Ioanăş¹,

Angrill²,

Baldó³

et al. 2002

Eur Respir J

View full text Add to dashboard Cite

The pattern and clinical implications of bronchial bacterial colonization have been widely investigated in patients with chronic lung disease, particularly chronic obstructive pulmonary disease. The main aim of this study was to determine the frequency and risk factors for bronchial colonization in lung cancer patients who have undergone surgical resection.Forty-one patients with resectable lung cancer (22 (54%) active smokers, 52¡23 pack-yrs) with a mean forced expiratory volume in one second of 80 ¡ 16% predicted, were studied with bilateral protected specimen brush and lung tissue biopsy during the surgical procedure. Quantitative bacterial culture, susceptibility tests and histological examination of samples were performed.Bronchial colonization with o1 potential pathogenic micro-organism was found in 17 of 41 (41%) patients. The most frequent strains isolated were: Haemophilus influenzae (35%), Streptococcus pneumoniae (13%) and Pseudomonas spp. (9%). The risk factors for bronchial colonization were central location of the tumour (odds ratio (OR)=9.2, confidence interval (CI) 95%=2.1-39.6, p=0.003) and increased body mass index (OR=1.6, CI 95%=1.2-2.2, p=0.005). The frequency of postoperative infectious pulmonary complications was low (five cases (12%)) and no relationship was observed with bronchial colonization.Patients with resectable lung carcinoma had a high rate of bronchial colonization (41%), mainly with potential pathogenic microorganisms. The independent risk factors for colonization in these patients were central location of the tumour and a high body mass index.

show abstract

Initial Bacterial Colonization in Patients Admitted to a Respiratory Intensive Care Unit:Bacteriological Pattern and Risk Factors

Cited by 39 publications

References 34 publications

Anaerobic bacteria colonizing the lower airways in lung cancer patients

Anaerobic bacteria colonizing the lower airways in lung cancer patients

Determinants of the Length of Mechanical Ventilation in Patients with COPD in the Intensive Care Unit

Bronchial bacterial colonization in patients with resectable lung carcinoma

Contact Info

Product

Resources

About