Prior antimicrobial therapy duration influences causative pathogens identification in ventilator-associated pneumonia

Llitjos, Jean-François; Amara, Marlène; Benzarti, A; Lacave, Guillaume; Bédos, Jean‐Pierre; Pangon, B.

doi:10.1016/j.jcrc.2017.10.027

Cited by 4 publications

(2 citation statements)

References 11 publications

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“…The aetiological agents of VAP may extensively differ according to several factors including the population of the patients in ICU, duration of hospital stay and prior antimicrobial therapy [23] and co-morbid conditions [17]. In addition, previous extensive exposure to antimicrobials increases the risk of developing MDR pathogens [25]. It was reported that the most common causative pathogens of VAP, especially in patients with underlying serious diseases, include aerobic Gram-negative bacilli such as P. aeruginosa, E. coli, K. pneumoniae and Acinetobacter species, besides Gram-positive bacteria such as S. aureus [26].…”

Section: Discussionmentioning

confidence: 99%

Microbiological profile of ventilator-associated pneumonia among intensive care unit patients in tertiary Egyptian hospitals

Farag

Tawfick

Abozeed

et al. 2020

J Infect Dev Ctries

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Introduction: Ventilator-associated pneumonia (VAP) is one of the common serious infectious diseases encountered in the intensive care unit (ICU), which highly affects the healthcare cost and patient prognosis. VAP is caused by various antimicrobial-resistant aetiological agents and the clinical manifestations lack sensitivity and specificity, making the prompt treatment is a challenge. This study aimed to investigate the microbial profile of VAP causing microorganisms among ICU patients in Egypt, antimicrobial susceptibility patterns and the genetic diversity among the frequently isolated organisms. Methodology: Throughout the period from August 2016 to August 2017, endotracheal aspirate (ETA) specimens were collected from ICU patients with clinically suspected VAP in two tertiary hospitals in Cairo. ETA specimens were investigated for the microbial content. The antimicrobial susceptibility was determined by the Kirby-Bauer method. ERIC-PCR was performed for genotyping. Results: Fifty microbiologically confirmed VAP cases were identified. The most frequently isolated microorganisms were Klebsiella spp., followed by Pseudomonas aeruginosa, Acinetobacter baumannii. Candida spp. was the most isolated fungi. A single isolate of each Cupriavidus pauculus and Aeromonas salmonicida was isolated. Antimicrobial susceptibility profiles indicated 40% of isolates were multidrug-resistant (MDR). ERIC-PCR revealed no genetic relatedness among K. pneumoniae isolates, the most frequently isolated microorganism. Conclusions: Gram-negative bacteria are the main causative agents of VAP cases, which mostly are MDR. Microorganisms like C. pauculus and A. salmonicida should be taken into consideration as VAP causative agents. There was no common source of infection suggesting likely endogenous sources of K. pneumoniae, the main causative agent of VAP in this study.

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Section: Discussionmentioning

confidence: 99%

Microbiological profile of ventilator-associated pneumonia among intensive care unit patients in tertiary Egyptian hospitals

Farag

Tawfick

Abozeed

et al. 2020

J Infect Dev Ctries

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“…Primary pulmonary or non-pulmonary insults may differentially impact on lung defense and modulate the further susceptibility to superimposed infectious insults. The regimen and duration of prior antibiotics may also impact on the type of pathogens involved in ventilator-associated pneumonia and their eventual susceptibility to antimicrobials [16]. We also found that male patients had an increased risk of developing pulmonary ICU-AI.…”

Section: Discussionmentioning

confidence: 75%

Pulmonary infections prime the development of subsequent ICU-acquired pneumonia in septic shock

Llitjos

Gassama

Charpentier

et al. 2019

Ann. Intensive Care

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PurposeTo investigate the determinants and the prognosis of intensive care unit (ICU)-acquired pneumonia in patients with septic shock.MethodsThis single-center retrospective study was conducted in a medical ICU in a tertiary care center from January 2008 to December 2016. All consecutive patients diagnosed for septic shock within the first 48 h of ICU admission were included. Patients were classified in three groups: no ICU-acquired infections (no ICU-AI), ICU-acquired pneumonia and non-pulmonary ICU-AI. The determinants of ICU-acquired pneumonia and death were investigated by multivariate competitive risk analysis.ResultsA total of 1021 patients were admitted for septic shock, and 797 patients were alive in the ICU after 48 h of management. The incidence of a first episode of ICU-AI was 31%, distributed into pulmonary (17%) and non-pulmonary ICU-AI (14%). Patients with septic shock caused by pneumonia were at increased risk of further pulmonary ICU-AI with a cumulated incidence of 34.4%. A pulmonary source of the initial septic shock was an independent risk factor for subsequent ICU-acquired pneumonia (cause-specific hazard 2.33, 95% confidence interval [1.55–3.52], p < 0.001). ICU-AI were not associated with a higher risk of ICU mortality after adjustment in a multivariate-adjusted cause-specific proportional hazard model.ConclusionSeptic shock of pulmonary origin may represent a risk factor for subsequent ICU-acquired pneumonia without affecting mortality.Electronic supplementary materialThe online version of this article (10.1186/s13613-019-0515-x) contains supplementary material, which is available to authorized users.

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Comparison of traditional microbiological culture and 16S polymerase chain reaction analyses for identification of preoperative airway colonization for patients undergoing lung resection

Howitt

Blackshaw

Fontaine

et al. 2018

Journal of Critical Care

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Prior antimicrobial therapy duration influences causative pathogens identification in ventilator-associated pneumonia

Cited by 4 publications

References 11 publications

Microbiological profile of ventilator-associated pneumonia among intensive care unit patients in tertiary Egyptian hospitals

Microbiological profile of ventilator-associated pneumonia among intensive care unit patients in tertiary Egyptian hospitals

Pulmonary infections prime the development of subsequent ICU-acquired pneumonia in septic shock

Comparison of traditional microbiological culture and 16S polymerase chain reaction analyses for identification of preoperative airway colonization for patients undergoing lung resection

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