scholarly journals Distribution and antibiotic susceptibility of pathogens isolated from adults with hospital-acquired and ventilator-associated pneumonia in intensive care unit

2017 ◽  
Vol 10 (6) ◽  
pp. 740-744 ◽  
Author(s):  
Zorana M. Djordjevic ◽  
Marko M. Folic ◽  
Slobodan M. Jankovic
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Antibiotic Susceptibility ◽  
Ventilator Associated Pneumonia ◽  
Hospital Acquired

scholarly journals The effect of prior antimicrobial therapy for community acquired infections on the aetiology of early and late onset ventilator-associated pneumonia in a level I trauma intensive care unit

2017 ◽  
Vol 32 (3) ◽  
pp. 91-95
Author(s):  
Yogandree Ramsamy ◽  
David J.J. Muckart
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Antimicrobial Therapy ◽  
Late Onset ◽  
Bacterial Flora ◽  
First Episode ◽  
Ventilator Associated Pneumonia ◽  
Bacterial Isolates ◽  
Prior Therapy ◽  
Hospital Acquired

Background: Ventilator-associated pneumonia (VAP) is the most common hospital acquired infection in patients who require mechanical ventilation. Early VAP is associated with community acquired pathogens whereas late VAP involves hospital flora. Based on this premise, a protocol may be formulated for microbiological surveillance and antimicrobial stewardship within a specific intensive care unit (ICU) to ensure appropriate empiric antimicrobial choice. The bacterial flora in VAP may be affected, however, by antimicrobials prescribed during the ICU stay. Aim: The aim of this study was to determine the effect of prior antimicrobial therapy for community acquired infections on aetiology and the susceptibility of bacterial isolates from the first episode of early or late VAP in a trauma intensive care unit.Methods: Endotracheal aspirates (ETAs) were obtained from patients with suspected early and late VAP. All ETAs were processed and interpreted as per the Clinical and Laboratory Standards Institute (CLSI). Patients were divided into two cohorts: those whose injuries had required antimicrobial therapy for community acquired infections and those who were antimicrobial naïve. The effect of prior antimicrobial therapy on bacterial isolates from the first episode of suspected VAP was compared between the two groups.Results: Of 288 patients admitted to the Trauma ICU between January and December 2014, pneumonia was suspected in 91 (31.6%). Of these, 69 (76%) patients were antimicrobial naïve and 22 (24%) had received prior antimicrobial therapy. Early VAP occurred in 31 (45%) patients in the naïve cohort compared to 3 (12.5%) with prior antimicrobial exposure (p = 0.01). Of the early VAP isolates 25 (81%) in the naïve cohort contained community flora, whereas all isolates in those with prior antimicrobial therapy revealed hospital acquired organisms (p = 0.01). In the antimicrobial naïve cohort with late VAP 27 (71%) patients had community acquired organisms, whereas only 3 (16%) isolates in late VAP in those with prior therapy revealed community acquired flora (p 0.001).Conclusion: Patients who receive prior antimicrobial therapy have a significantly lower incidence of early VAP, but in those who developed either early or late VAP hospital acquired pathogens were more commonly isolated. Knowledge of prior antimicrobial exposure in a patient with early or late VAP will assist in determining the correct empiric antimicrobial choice.

scholarly journals Use of Ventilator Bundle and Staff Education to Decrease Ventilator-Associated Pneumonia in Intensive Care Patients

2016 ◽  
Vol 36 (5) ◽  
pp. e1-e7 ◽  
Author(s):  
Maria Parisi ◽  
Vasiliki Gerovasili ◽  
Stavros Dimopoulos ◽  
Efstathia Kampisiouli ◽  
Christina Goga ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Length Of Stay ◽  
Ventilator Associated Pneumonia ◽  
Staff Education ◽  
Hospital Acquired Infections ◽  
Intensive Care Patients ◽  
Greek Hospital ◽  
Hospital Acquired

BackgroundVentilator-associated pneumonia (VAP), one of the most common hospital-acquired infections, has a high mortality rate.ObjectivesTo evaluate the incidence of VAP in a multidisciplinary intensive care unit and to examine the effects of the implementation of ventilator bundles and staff education on its incidence.MethodsA 24-month-long before/after study was conducted, divided into baseline, intervention, and postintervention periods. VAP incidence and rate, the microbiological profile, duration of mechanical ventilation, and length of stay in the intensive care unit were recorded and compared between the periods.ResultsOf 1097 patients evaluated, 362 met the inclusion criteria. The baseline VAP rate was 21.6 per 1000 ventilator days. During the postintervention period, it decreased to 11.6 per 1000 ventilator days (P = .01). Length of stay in the intensive care unit decreased from 36 to 27 days (P = .04), and duration of mechanical ventilation decreased from 26 to 21 days (P = .06).ConclusionsVAP incidence was high in a general intensive care unit in a Greek hospital. However, implementation of a ventilator bundle and staff education has decreased both VAP incidence and length of stay in the unit.

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