Pharmaceutical strategies to prevent ventilator-associated pneumonia

Abstract

The increasing incidence of hospital-acquired (nosocomial) infection is a disturbing phenomenon resulting in significant patient mortality and putting considerable strain on healthcare budgets and personnel. One particularly serious aspect of nosocomial infection is that of ventilator-associated pneumonia (VAP). This arises in patients who receive mechanical ventilation within the intensive care unit. The quoted incidence of VAP varies widely (5-67%) and the reported mortality of patients with VAP is in the range of 24-71%. This review will examine the many factors that account for these wide ranges reported, including the patient population under investigation, the causative organism, the method of diagnosis, interventions employed and preventative strategies. The use of bioactive and drug-impregnated biomaterials for endotracheal tube construction is discussed as novel approaches to the prevention of VAP.

Microbiology, resistance patterns, and risk factors of mortality in ventilator-associated bacterial pneumonia in a Northern Thai tertiary-care university based general surgical intensive care unit

“…Different studies reported varied VAP incidence rates ranging from 5% to 67%, which may be confounded by the presence of mixed populations with variable age groups, underlying conditions, other associated risk factors, and using different gold standards for diagnosis 16. The National Nosocomial Infections Surveillance System of the CDC reported the median rate of VAP cases per 1,000 MVD in the US was higher in SICUs (range 6.2–11.4) than in medical ICUs (3.7) 17.…”

Hydrogel Antimicrobial Capture Coatings for Endotracheal Tubes: A Pharmaceutical Strategy Designed to Prevent Ventilator-Associated Pneumonia

“…S. aureus and Ps. aeruginosa have emerged as the principal causative organisms of ventilator-associated pneumonia 48,49 . Therefore clinical isolates of these pathogens were selected to evaluate the antimicrobial properties of the candidate hydrogels.…”

Physicochemical characterisation and biological evaluation of hydrogel-poly(ε-caprolactone) interpenetrating polymer networks as novel urinary biomaterials

“…Medical device related infection is common to all medical devices and results following attachment of pathogenic bacteria onto the outer surface or lumen of the medical device. Bacteria may then adopt a biofilm growth mode, dislodge from the biofilm and initiate infection in the surrounding tissue [1,[3][4][5]. Encrustation involves the deposition of crystalline deposits onto the outer surface/lumen of urinary medical devices and is frequently due to bacterial alkalisation of the urine [1,6].…”