Relationship of Microbiologic Diagnostic Criteria to Morbidity and Mortality in Patients With Ventilator-Associated Pneumonia

Brégeon, Fabienne; Papazian, Laurent; Visconti, Alexandre; Gregoire, R.; Thirion, Xavier; Gouin, F.

doi:10.1001/jama.1997.03540320057036

Cited by 53 publications

(12 citation statements)

References 46 publications

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“…There are no comparable data from other cost-of-illness studies. However, the importance of identifying the pathogen and thus allowing selective treatment in NP cannot be overemphasized for this critically ill patient group, with all methodological limitations in mind which make multiple investigations necessary to come to a valid conclusion on the etiological agent [29].…”

Section: Discussionmentioning

confidence: 99%

Nosocomial Pneumonia: A Cost-of-Illness Analysis

et al. 2002

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The study gives insight into the structure of incremental cost caused by NP and shows that based on a conservative cost calculation the incremental cost per NP patient is higher for the hospital than for health insurance funds which indicates a significant financial deficit for the hospital. Antibiotics and microbiology together only contribute 6.8% to incremental cost. Therefore in a cost saving initiative their close relationship to length of hospitalization must be considered.

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Section: Discussionmentioning

confidence: 99%

Nosocomial Pneumonia: A Cost-of-Illness Analysis

et al. 2002

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“…Kaplan-Meier rates of colonization were 7.03 after versus 2.21 before Day 8, a result confirmed by actuarial life table method and multivariate analysis of risk factors. The American Thoracic Society in its consensus statement (21) states that early ventilator-associated pneumonia and late-onset ventilatorassociated pneumonia should be differentiated according to a time period of 5 d. Possibly early, intermediate, and late forms of ventilator-associated pneumonia using 6 to 13 d as cutoff should be described based on the pathogens occurring during this time period and their associated outcomes (22). But we only sampled every 7 d, therefore we did not know if P. aeruginosa ventilated-associated pneumonia was intermediate or late forms.…”

Section: Discussionmentioning

confidence: 99%

Risks and Routes for Ventilator-Associated Pneumonia with Pseudomonas aeruginosa

Talon¹,

Mulin²,

Rouget³

et al. 1998

Am J Respir Crit Care Med

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In a prospective study, we screened specimens from 190 mechanically ventilated patients hospitalized in a surgical intensive care unit, and from the environment to assess risks and routes of colonization/infection. Specimens from various sites were collected on admission and once a week throughout each patient's stay. All P. aeruginosa isolates were typed by determination of DNA patterns. Data were collected from patients to identify risk factors. In vitro production of exoenzymes of different strains were compared. Forty-four patients were colonized with P. aeruginosa on the bronchopulmonary tract and 13 suffered from pneumonia. The 7-d and 14-d Kaplan-Meier rates of colonization were 2.21 and 7.03%. Twenty-one patterns of bronchopulmonary tract isolates were isolated from single patients and 10 from several patients. The lower airway was often the first site of colonization. The contribution of environment to patient colonization appeared to be small. The length of hospitalization, the previous use of third-generation cephalosporins less effective against P. aeruginosa, and chronic obstructive pulmonary disease were the most significant predictors of colonization/infection. The in vitro exoprotein production was not correlated with the presence of pneumonia. Our study may be useful in identifying which patients in the mechanically ventilated population are at greater risk of P. aeruginosa pneumonia.

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“…Once critically ill patients are infected, it is extremely difficult to eradicate the P. aeruginosa infection. Mortality approaches 40% in this population [10].…”

Section: Introductionmentioning

confidence: 93%