Candida spp. airway colonization could promote antibiotic-resistant bacteria selection in patients with suspected ventilator-associated pneumonia

Abstract

In patients with suspected VAP, Candida spp. airway colonization is frequent and associated with increased risk for MDR bacteria isolation. This could worsen outcome and should therefore be considered when choosing an empiric antibiotic therapy.

Pathophysiology of Escherichia coli ventilator-associated pneumonia: implication of highly virulent extraintestinal pathogenic strains

“…More recent data even suggest that Enterobacteriaceae (and among them E. coli) are now more often responsible for VAP than P. aeruginosa and Staphylococcus aureus [34,35]. Our local epidemiology of VAP is in agreement with these recent findings.…”

Candida colonization of respiratory tract: to treat or not to treat, will we ever get an answer?

“…A wide range of metabolic processes and cellto-cell communications through QS molecules are the basis of both synergistic and antagonistic interactions. Interestingly, in a prospective observational study, RT Cc was identified as an independent predictor of multidrugresistant bacteria airway isolation in patients with suspected VAP [12]. As a result of the exiguous number of microbiologically confirmed VAP in the CANTREAT study, no conclusions may be drawn about these phenomena.…”

“…is not definitely an innocent bystander in the respiratory tract of ICU ventilated patients [3][4][5][6][7][8][9][10][11][12][13] (Table 1). Beta-glucan (BG), a component of yeast cell wall, may act as a lung proinflammatory agent causing alveolar macrophage and neutrophil dysfunction.…”

“…BG positivity was associated with increased 28-day mortality (p = 0.03) Delisle et al [11] Retrospective exploratory analysis 274 pts (68 with Cc RT/VAP) Candida spp. was associated with increased hospital mortality (p \ 0.001) Hamet et al [12] Prospective observational study 323 pts (181 with Cc RT/csVAP) CC RT was an independent risk factor for MDR bacteria isolation (OR 1.79, 95 % CI 1.05-3.05, p = 0.03) Ong et al [13] Observational cohort study 333 episodes of RT Cc episodes (59 received NAB)…”

Pilzpneumonien: Gibtʼs die?

“…In der S3-Leitlinie für ambulant erworbene Pneumonie [10] [14,15,16]. Die Funktion der Makrophagen in der Lunge wird näm-lich durch Candida vermindert [17]; folglich ist eine Kolonisierung mit Candida ernst zu nehmen und bei beatmeten Patienten auf einer Intensivstation eine antimykotische Therapie zur Reduktion der Keimlast durchaus zu überlegen, wenn andere prä-ventive Maßnahmen nicht greifen.…”