Assessment of Severity of ICU-Acquired Pneumonia and Association With Etiology

Abstract

In patients with ICU-acquired pneumonia, severity of illness seems not to affect etiology. Risk factors for multidrug resistant, but not severity of illness, should be taken into account in selecting empiric antimicrobial treatment.

The respiratory threat posed by multidrug resistant Gram‐negative bacteria

“…In addition, Koulenti et al . described a prevalence of 51% for Enterobacteriaceae among 827 patients with HAP and VAP in a multicentre prospective study in Europe and Di Pasquale showed that Enterobacteriaceae was responsible for 47% of ICU‐acquired pneumonia in Spain.…”

Impact of COPD in the Outcome of ICU-Acquired Pneumonia With and Without Previous Intubation

“…2 The microbiologic evaluation was extensively addressed in previous reports. 15,16 Briefl y, we collected at least one lower respiratory airways sample (sputum in nonintubated patients or tracheobronchial aspirates in those intubated), and BAL if possible, within the fi rst 24 h of inclusion. Blood cultures and cultures from pleural fluid if puncture was indicated were also taken.…”

“…We also noted the presence of multidrug-resistant pathogens. 16 Th e initial empirical antimicrobial treatment was administered according to local adaptation of guidelines, 1 based on the most frequently isolated pathogens and their patterns of antimicrobial sensitivity in our institution, and subsequently revised according to the microbiologic results. We noted the development of predictors of adverse outcomes aft er 72 to 96 h of antimicrobial treatment to assess the initial response to treatment, as previously described.…”

“…a In two patients without COPD, more than one Enterobacteriaceae was identifi ed. TNF-a , pg/mL 9 (6-16) 7 (4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14) .43 7 (5-10) 11 (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18) .12…”

Early Identification of Ventilator-associated Pneumonia Causative Pathogens: Focus on the Value of Gram-stain Examination

“…Patients at risk of being colonized by MDR pathogens are extremely varied, commonly present comorbid conditions, are ventilated for longer periods of time and receive antibiotics during the course of their hospitalization. A recent study [8] demonstrated that severity of illness did not affect etiology and risk factors for MDR pathogens. The incidence of MDR pathogens is also closely linked to local factors and varies widely from one institution to another [9].…”