Risk factors for mortality in ventilator-associated tracheobronchitis: a case-control study

Abstract

Objective To describe the microbiological characteristics and to assess the risk factors for mortality of ventilator-associated tracheobronchitis in a case-control study of intensive care patients.Methods This case-control study was conducted over a 6-year period in a 40-bed medical-surgical intensive care unit in a tertiary care, private hospital in São Paulo, Brazil. Case patients were identified using the Nosocomial Infection Control Committee database. For the analysis of risk factors, matched control subjects were selected from the same institution at a 1:8.8 ratio, between January 2006 and December 2011.Results A total of 40 episodes of ventilator-associated tracheobronchitis were evaluated in 40 patients in the intensive care unit, and 354 intensive care patients who did not experience tracheobronchitis were included as the Control Group. During the 6-year study period, a total of 42 organisms were identified (polymicrobial infections were 5%) and 88.2% of all the microorganisms identified were Gram-negative. Using a logistic regression model, we found the following independent risk factors for mortality in ventilator-associated tracheobronchitis patients: Acute Physiology and Chronic Health Evaluation I score (odds ratio 1.18 per unit of score; 95%CI: 1.05-1.38; p=0.01), and duration of mechanical ventilation (odds ratio 1.09 per day of mechanical ventilation; 95%CI: 1.03-1.17; p=0.004).Conclusion Our study provided insight into the risk factors for mortality and microbiological characteristics of ventilator-associated tracheobronchitis.

Enteral Ciprofloxacin or Levofloxacin for Ventilator-Associated Tracheobronchitis in Children

“…While this present study did not assess organism resistance to other antibiotics, only 15 (7%) isolates were reported to be resistant to the fluoroquinolone used, with only one known patient proceeding to develop a clinically-relevant fluoroquinolone-resistant infection. The most commonly isolated organism in this study was P. aeruginosa , which is similar to the results of other studies in both pediatric 8 and adult critically ill patients 7,19,20 . S. aureus was also commonly isolated, again corroborated by pediatric and adult evidence 7,8,19 .…”