Diagnosis of ventilator-associated pneumonia: Comparison between ante-mortem and post-mortem cultures in trauma patients

Lalwani, Sanjeev; Mathur, Purva; Tak, Vibhor; Janani, S; Kumar, Saurabh; Bagla, Ritu; Misra, MC

doi:10.4103/0255-0857.136572

Cited by 10 publications

(10 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A high prevalence of multidrug resistance is seen at our center in all genera of Gram-negative bacteria. [ 13 ] Although not reported in the present study, we have observed that not all patients suffering from VAP with the same clone of A. baumannii have a fatal outcome. [ 14 ] Thus, there must be some host immune response-driven factors which propel a patient toward a poor outcome.…”

Section: Resultscontrasting

confidence: 52%

Bronchoalveolar lavage fluid cytokine bead array profile for prognostication of ventilated trauma patients

Kumar

Bhardwaj

Khurana

et al. 2016

Indian Journal of Critical Care Medicine

View full text Add to dashboard Cite

Aim of Study:Ventilator-associated pneumonia (VAP) is a common cause of mortality in trauma patients admitted to Intensive Care Units. The outcome of such patients may be dependent on local host immune response, which may be best reflected in studies using bronchoalveolar lavage (BAL) fluid. The present study was conducted to ascertain the cytokine profile of BAL using the cytometric bead array (CBA) in a flow cytometer and to correlate the levels of Th-1/Th-2 cytokines in BAL with the clinical outcome of ventilated trauma patients.Patients and Methods:BAL was collected from the patients with suspected VAP. CBA was performed to assess the levels of interleukin-4 (IL-4), IL-6, IL-8, IL-1 β, interferon gamma (IFN-γ), and tumor necrosis factor-alpha in the BAL samples. After acquiring the BAL samples on the flow cytometer, the results were generated using FCAP Array™ software. The cytokine profile was correlated to clinical outcomes.Results:A total of forty patients were enrolled during the study period. Of these, 12 patients (30%) had confirmed VAP and 8 (20%) patients had a fatal outcome. The levels of IL-8 and IFN-γ correlated significantly with the development of VAP and elevated IL-6 in BAL was associated with a poor outcome.Conclusion:A proinflammatory response in the form of elevated IL-6 and IL-8 correlated poorly with the clinical outcome. Th-1 response was significantly reduced in patients with VAP. A proinflammatory response in the form of elevated IL-6 and IL-8 correlated poorly with the clinical outcome.

show abstract

Section: Resultscontrasting

confidence: 52%

Bronchoalveolar lavage fluid cytokine bead array profile for prognostication of ventilated trauma patients

Kumar

Bhardwaj

Khurana

et al. 2016

Indian Journal of Critical Care Medicine

View full text Add to dashboard Cite

show abstract

“…was seen. This observation was in agreement with other researchers' like Singh et al (2010) [ 9 ] and Lalwani et al (2014) [ 28 ]. Therefore, it can be stated that VAP may be caused by a wide spectrum of bacterial pathogens but rarely due to mycotic pathogens.…”

Section: Discussionsupporting

confidence: 94%

“…VAP remains an important cause of morbidity and mortality despite advances in antimicrobial therapy, better supportive care modalities, and the use of a wide range of preventive measures [ 28 ]. It complicates the course of 8–28% of the patients on mechanical ventilation [ 28 ]. In the present study, the rate of VAP per 1000 device days was found to be 3.3, which is quite low in comparison to that reported by other researchers.…”

Section: Discussionmentioning

confidence: 99%

Medical Device-AssociatedCandidaInfections in a Rural Tertiary Care Teaching Hospital of India

Deorukhkar

Saini

2016

Interdisciplinary Perspectives on Infectious Diseases

View full text Add to dashboard Cite

Health care associated infections (HCAIs) add incrementally to the morbidity, mortality, and cost expected of the patient's underlying diseases alone. Approximately, about half all cases of HCAIs are associated with medical devices. As Candida medical device-associated infection is highly drug resistant and can lead to serious life-threatening complications, there is a need of continuous surveillance of these infections to initiate preventive and corrective measures. The present study was conducted at a rural tertiary care hospital of India with an aim to evaluate the rate of medical device-associated Candida infections. Three commonly encountered medical device-associated infections (MDAI), catheter-associated urinary tract infection (CA-UTI), intravascular catheter-related blood stream infections (CR-BSI), and ventilator-associated pneumonia (VAP), were targeted. The overall rate of MDAI in our hospital was 2.1 per 1000 device days. The rate of Candida related CA-UTI and CR-BSI was noted as 1.0 and 0.3, respectively. Untiring efforts taken by team members of Hospital Acquired Infection Control Committee along with maintenance of meticulous hygiene of the hospital and wards may explain the low MDAI rates in our institute. The present surveillance helped us for systematic generation of institutional data regarding MDAI with special reference to role of Candida spp.

show abstract

“…All the specimens were immediately processed in the Department of Microbiology. The specimens were directly inoculated onto MacConkey agar and Blood agar media by quantitative culture method [6]. The plates were kept for overnight incubation at 37 °C.…”

Section: Methodsmentioning

confidence: 99%

Adaptations of carbapenem resistant Acinetobacter baumannii (CRAB) in the hospital environment causing sustained outbreak

Sharma

Das

Banerjee

et al. 2021

Journal of Medical Microbiology

View full text Add to dashboard Cite

Introduction. Carbapenem resistance in Acinetobacter baumannii ( A. baumannii ) is an emerging global threat. Gap statement. The adaptation strategies of A. baumannii for this emergence as a nosocomial pathogen has been less studied. Aim. This prospective study analysed a sustained outbreak of carbapenem resistant Acinetobacter baumannii (CRAB) in the intensive care unit (ICU) with reference to antimicrobial resistance and virulence in the colonizing and pathogenic isolates under carbapenem stress. Results. The CRAB isolates from initial and sustained outbreak were found harbouring multiple carbapenemase genes. These genes included bla OXA-23 ,bla IMP, bla VIM and bla NDM. From NICU environment three phenotypically carbapenem susceptible isolates were found carrying bla OXA-23, bla IMP, bla VIM genes. Prior imipenem therapy was one of the risk factors (P=0.0016). The outbreak was polyclonal. Under imipenem stress, outbreak isolates showed no loss of carbapenemase genes against stress free conditions (23.7±1.33 days). Biofilm formation increased with imipenem concentration, with outbreak isolates producing highest biomass. While the pathogens showed a slow growth rate on imipenem exposure, the colonisers grew rapidly (P <0.0001). Methods. Sustained outbreak of CRAB was identified in the ICU (July 2015 to December 2017). Risk factors for acquisition of CRAB was studied. A. baumannii isolates were also collected from the environments of ICU and neonatal ICU (NICU) and blood cultures of septic neonates. Isolates were characterized based on antimicrobial susceptibility, genetic profile, integrons carriage and clonality. Biofilm formation and growth kinetics were studied under varying carbapenem stress. Conclusion. Intense carbapenem exposure in the ICU facilitates persistence of CRAB by several adaptations causing sustained outbreaks.

show abstract

Diagnosis of ventilator-associated pneumonia: Comparison between ante-mortem and post-mortem cultures in trauma patients

Abstract: Culture results of a properly collected tracheal aspirate should be taken into consideration along with Centre for Disease Control and Prevention (CDC's) diagnostic criteria to maximise the diagnosis of VAP.

Cited by 10 publications

References 15 publications

Bronchoalveolar lavage fluid cytokine bead array profile for prognostication of ventilated trauma patients

Bronchoalveolar lavage fluid cytokine bead array profile for prognostication of ventilated trauma patients

Medical Device-AssociatedCandidaInfections in a Rural Tertiary Care Teaching Hospital of India

Adaptations of carbapenem resistant Acinetobacter baumannii (CRAB) in the hospital environment causing sustained outbreak

Contact Info

Product

Resources

About