Treatment of ventilator-associated pneumonia and ventilator-associated tracheobronchitis in the intensive care unit

Al‐Omari, Awad; Mohammed, Masood; Alhazzani, Waleed; Al‐Dorzi, Hasan M.; Belal, Mohammed S.; Albshabshe, Ali; Al-Subaie, Maha F.; Arabi, Yaseen M.

doi:10.15537/smj.2015.12.12345

Cited by 3 publications

(3 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Therefore, medical devices such as humidifiers, intubation tubes, and ventilators are important sources for nosocomial infections caused by Chryseobacterium spp [1] , [13] . VAP incidence is estimated to be 10–25% in Saudi Arabia and is associated with 25–50% mortality rates of these cases [14] . Environmental and mechanical ventilator samples did not grow any C .…”

Section: Discussionmentioning

confidence: 99%

Chryseobacterium gleum pneumonia in an infant with nephrotic syndrome

Abdalhamid

Elhadi

Alsamman

et al. 2016

IDCases

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Chryseobacterium gleum pneumonia in an infant with nephrotic syndrome

Abdalhamid

Elhadi

Alsamman

et al. 2016

IDCases

View full text Add to dashboard Cite

show abstract

“…[11] Kumar et al [26] reported that delay in antibiotic treatment, especially in patients with septic shock, was associated with increased mortality. In a survey conducted by Al-Omari et al, [27] more than 50% of the participants reported that they preferred to start empirical intravenous colistin in the presence of septic shock in late-onset VAP patients. In our study, intensive care mortality and septic shock rates were higher in VAP cases, although in other studies they were similar.…”

Section: Discussionmentioning

confidence: 99%

Clınıcal sıgnıfıcance of mınor cytologıcal abnormalıtıes: atypıcal squamous cells of undetermıned sıgnıfıcance (ASCUS) 8 year experience

Sakin¹

2015

Kartal TR

View full text Add to dashboard Cite

Objective: Ventilator-associated pneumonia (VAP) due to Acinetobacter baumannii (A. baumannii) has a high mortality rate in the intensive care unit (ICU). The guidelines recommend empirical antimicrobial therapy in cases of VAP; however, similar treatment is not recommended in cases of ventilator-associated tracheobronchitis (VAT) with a culture result of A. baumannii. The aim of this study was to evaluate the difference in the ICU and long-term mortality of patients with A. baumannii VAP and VAT who were treated with antibiotherapy. Methods:This was a retrospective cohort study. Patients who were intubated in the respiratory ICU due to acute respiratory failure (ARF) and developed A. baumannii-associated VAP or VAT between January 2015 and January 2016 were included in this study. Demographic features, comorbidities, cause of ARF, arterial blood gas values, oxygenation level, chest X-ray findings, ICU severity scores (Sequential Organ Failure Assessment [SOFA] score, Charlson Comorbidity Index score, Acute Physiology and Chronic Health Evaluation II score), culture antibiotic susceptibility results, antibiotic regimen, length of ICU stay, and mortality details were recorded. Long-term mortality (1-, 2-, 3-, 12-month) details were obtained from national death records. The Kaplan-Meier method was used for long-term survival analysis. , 78 (15.5%) who had A. baumannii-associated VAT and VAP were included. Of the 78 patients, 21 (35%) were cases of VAP and 50 (65%) were cases of VAT. Diagnoses of the 78 patients were 62% chronic obstructive pulmonary disease, 15% pneumonia, 10% acute cardiogenic pulmonary edema, 9% lung cancer, and 4% kyphoscoliosis. Among the VAP patients, 21 (75%) were male and 7 (25%) were female, while among the VAT patients, 38 (76%) were male and 12 (24%) were female. There was no statically significant difference between the VAP and VAT patients according to age, gender, comorbidities, the presence of acute respiratory distress syndrome or septic shock, Charlson and SOFA scores, or length of hospital and ICU stay. The median (quartile ratio) duration of mechanical ventilator use was 15 days (7-22 days) for VAP patients and 12 days (6-14 days) for VAT patients (p=0.649). The ICU mortality rate was 68% among VAP patients and 40% among VAT patients (p<0.018). The length of the median follow-up after discharge (25%-75%) for VAT patients (n=30) and VAP (n=9) patients was 407 days (34-574 days) and 112 days (34-524 days), respectively (p=0.852). Kaplan-Meier survival analysis was similar for both VAP and VAT patients (p=0. 57). The 1-, 2-, 3-, and 12-month mortality in VAP and VAT patients was 11.1% and 16.6% (p=0.69), 44.4%, and 26.7% (p=0.31), 44.4% and 33.3% (p=0.54), and 66.7% and 46.7%, respectively (p=0.29). Conclusion:Despite antimicrobial treatment for A. baumannii, 2 of every 3 VAP patients and 2 of every 5 VAT patients died. Nonetheless, though antibiotic treatment is not currently recommended for VAT, these results suggest that mortality might be higher in A. baumannii-associated VAT wit...

show abstract

“…The IDSA guidelines recommend against the routine use of colistin in treating VAP while European guidelines similarly state the empiric therapy to be guided by the mortality risk, local ecology, and other MDR selection risk factors [ 10 , 22 ]. Yet, colistin-based combination therapy is still used in some critical care centers to empirically treat XDR pathogens [ 43 ]. Less common VAP bacterial pathogens include Stenotrophomonas maltophilia , Burkholderia cepacia , Legionella , and anaerobes which are known for their intrinsic resistance to multiple antimicrobial classes [ 44 , 45 ].…”

Section: Microbiology In Vapmentioning

confidence: 99%

Antimicrobial Resistance in Ventilator-Associated Pneumonia: Predictive Microbiology and Evidence-Based Therapy

Alnimr

2023

Infect Dis Ther

View full text Add to dashboard Cite

Ventilator-associated pneumonia (VAP) is a serious intensive care unit (ICU)-related infection in mechanically ventilated patients that is frequent, as more than half of antibiotics prescriptions in ICU are due to VAP. Various risk factors and diagnostic criteria for VAP have been referred to in different settings. The estimated attributable mortality of VAP can go up to 50%, which is higher in cases of antimicrobial-resistant VAP. When the diagnosis of pneumonia in a mechanically ventilated patient is made, initiation of effective antimicrobial therapy must be prompt. Microbiological diagnosis of VAP is required to optimize timely therapy since effective early treatment is fundamental for better outcomes, with controversy continuing regarding optimal sampling and testing. Understanding the role of antimicrobial resistance in the context of VAP is crucial in the era of continuously evolving antimicrobial-resistant clones that represent an urgent threat to global health. This review is focused on the risk factors for antimicrobial resistance in adult VAP and its novel microbiological tools. It aims to summarize the current evidence-based knowledge about the mechanisms of resistance in VAP caused by multidrug-resistant bacteria in clinical settings with focus on Gram-negative pathogens. It highlights the evidence-based antimicrobial management and prevention of drug-resistant VAP. It also addresses emerging concepts related to predictive microbiology in VAP and sheds lights on VAP in the context of coronavirus disease 2019 (COVID-19).

show abstract

Treatment of ventilator-associated pneumonia and ventilator-associated tracheobronchitis in the intensive care unit

Cited by 3 publications

References 27 publications

Chryseobacterium gleum pneumonia in an infant with nephrotic syndrome

Chryseobacterium gleum pneumonia in an infant with nephrotic syndrome

Clınıcal sıgnıfıcance of mınor cytologıcal abnormalıtıes: atypıcal squamous cells of undetermıned sıgnıfıcance (ASCUS) 8 year experience

Antimicrobial Resistance in Ventilator-Associated Pneumonia: Predictive Microbiology and Evidence-Based Therapy

Contact Info

Product

Resources

About