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Bacterial Pathogens of Ventilator Associated Pneumonia in a Tertiary Referral Hospital
Su Young Chi, M.D., Tae Ok Kim, M.D., Chan Woo Park, M.D., Jin Yeong Yu, M.D., Boram Lee, M.D., Ho Sung Lee, M.D., Yu Il Kim, M.D., Sung Chul Lim, M.D., Yong Soo Kwon, M.D.
Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
Tuberculosis and Respiratory Diseases; 2012 July; 73 (1): 32-37

FullText

Background : This study evaluates the bacterial pathogens of Ventilator-associated pneumonia (VAP) in a tertiary referral hospital.

Materials and Methods : A total of 109 bacterial pathogens from 91 adult patients with VAP, who were admitted to the medical intensive care unit from January 2008 to December 2009, were examined. Clinical characteristics, bacterial pathogens, and resistance profiles were analyzed.

Results : Staphylococcus aureus (44%) was the most frequently isolated. Acinetobacter baumanii (30%), Pseudomonas aeruginosa (12%), Stenotrophomonas maltophilia (7%), Klebsiella pneumoniae (6%), and Serratia marcescens (2%) were isolated from the transtracheal aspirates or bronchoalveolar lavage in patients with VAP. There was no significant difference of bacterial pathogens between early and late onset VAP. All isolated S. aureus were methicillin resistant S. aureus; the imipenem resistance rate of A. baumanii was 69%.

Conclusion : The two most frequent pathogens of VAP were S. aureus and A. baumanii. There were no pathogenic differences between early and late onset VAP.

Keywords : Pneumonia, Ventilator Associated; Staphylococcus aureus ; Acinetobacter baumanii

Reference :
1. Safdar N, Dezfulian C, Collard HR, Saint S. Clinical and economic consequences of ventilator-associated pneumonia: a systematic review. Crit Care Med 2005;33:2184-93.
2. Bell RC, Coalson JJ, Smith JD, Johanson WG Jr. Multiple organ system failure and infection in adult respiratory distress syndrome. Ann Intern Med 1983;99:293-8.
3. Celis R, Torres A, Gatell JM, Almela M, Rodríguez-Roisin R, Agustí-Vidal A. Nosocomial pneumonia: a multivariate analysis of risk and prognosis. Chest 1988;93:318-24.
4. Chevret S, Hemmer M, Carlet J, Langer M. Incidence and risk factors of pneumonia acquired in intensive care units: results from a multicenter prospective study on 996 patients. European Cooperative Group on Nosocomial Pneumonia. Intensive Care Med 1993;19:256-64.
5. Craven DE, Steger KA. Nosocomial pneumonia in mechanically ventilated adult patients: epidemiology and prevention in 1996. Semin Respir Infect 1996;11:32-53.
6. Cross AS, Roup B. Role of respiratory assistance devices in endemic nosocomial pneumonia. Am J Med 1981;70:681-5.
7. Fagon JY, Chastre J, Domart Y, Trouillet JL, Pierre J, Darne C, et al. Nosocomial pneumonia in patients receiving continuous mechanical ventilation: prospective analysis of 52 episodes with use of a protected specimen brush and quantitative culture techniques. Am Rev Respir Dis 1989;139:877-84.
8. Langer M, Mosconi P, Cigada M, Mandelli M. Longterm respiratory support and risk of pneumonia in critically ill patients. Intensive Care Unit Group of Infection Control. Am Rev Respir Dis 1989;140:302-5.
9. Vincent JL, Bihari DJ, Suter PM, Bruining HA, White J, Nicolas-Chanoin MH, et al. The prevalence of nosocomial infection in intensive care units in Europe. Results of the European Prevalence of Infection in Intensive Care (EPIC) Study. EPIC International Advisory Committee. JAMA 1995;274:639-44.
10. Chastre J, Fagon JY. Ventilator-associated pneumonia. Am J Respir Crit Care Med 2002;165:867-903.
11. Jones RN. Microbial etiologies of hospital-acquired bacterial pneumonia and ventilator-associated bacterial pneumonia. Clin Infect Dis 2010;51 Suppl 1:S81-7.
12. Richards MJ, Edwards JR, Culver DH, Gaynes RP. Nosocomial infections in combined medical-surgical intensive care units in the United States. Infect Control Hosp Epidemiol 2000;21:510-5.
13. Alcón A, Fàbregas N, Torres A. Hospital-acquired pneumonia: etiologic considerations. Infect Dis Clin North Am 2003;17:679-95.
14. Kollef MH, Shorr A, Tabak YP, Gupta V, Liu LZ, Johannes RS. Epidemiology and outcomes of healthcare-associated pneumonia: results from a large US database of culture-positive pneumonia. Chest 2005;128:3854-62.
15. Jeon K. Ventilator-associated pneumonia. Tuberc Respir Dis 2011;70:191-8.
16. Clinical and Laboratory Standards Institute. Performance standards for antimicrobial susceptibility testing: twentieth informational supplement. Document M100-S20. Wayne, PA: Clinical and Laboratory Standards Institute; 2010.
17. Chung DR, Song JH, Kim SH, Thamlikitkul V, Huang SG, Wang H, et al. High prevalence of multidrug-resistant nonfermenters in hospital-acquired pneumonia in Asia. Am J Respir Crit Care Med 2011;184:1409-17.
18. Luna CM, Aruj P, Niederman MS, Garzón J, Violi D, Prignoni A, et al. Appropriateness and delay to initiate therapy in ventilator-associated pneumonia. Eur Respir J 2006;27:158-64.
19. American Thoracic Society; Infectious Diseases Society of America. Guidelines for the management of adults with hospital-acquired, ventilator-associated, and healthcare-associated pneumonia. Am J Respir Crit Care Med 2005;171:388-416.
20. Lee K, Kim MN, Kim JS, Hong HL, Kang JO, Shin JH, et al. Further increases in carbapenem-, amikacin-, and fluoroquinolone-resistant isolates of Acinetobacter spp. and P. aeruginosa in Korea: KONSAR study 2009. Yonsei Med J 2011;52:793-802.
21. Lee SW, Jo HS, Kim WJ. Clinical characteristics of intensive care unit patients with carbapenem resistant Acinetobacter baumannii isolated from sputum. Tuberc Respir Dis 2006;60:228-34.

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