Relationship between nasal colonization and ventilator-associated pneumonia and the role of the environment in transmission of Staphylococcus aureus in intensive care units

Ventilator-associated Pneumonia in the ICU

“…Infectious bacteria obtain direct access to the lower respiratory tract via: (1) microaspiration, which can occur during intubation itself; (2) development of a biofi lm laden with bacteria (typically Gram-negative bacteria and fungal species) within the endotracheal tube; (3) pooling and trickling of secretions around the cuff ; and (4) impairment of mucociliary clearance of secretions with gravity dependence of mucus fl ow within the airways [11]- [13]. Pathogenic material can also collect in surrounding anatomic structures, such as the stomach, sinuses, nasopharynx and oropharynx, with replacement of normal fl ora by more virulent strains [11], [12], [14]. Th is bacterium-enriched material is also constantly thrust forward by the positive pressure exerted by the ventilator.…”

Microbiological study of ventilator associated pneumonia with antimicrobial susceptibility pattern of the isolated strains and its relation to nasal colonization in neonatal intensive care unit

“…The study of Rocha et al (2013) showed that S. aureus VAP represented 12.5% of the cases with statistical analysis which identified colonization as a risk factor for the development of this infection. This variability may be controlled by the guidelines of infection control followed and different antimicrobial policies in different institutions.…”

Effects of Chlorhexidine Solution Formula on Oral Health Status and Occurrence of Ventilator -Associated Pneumonia among Intubated Intensive Care Unit Patients

“…In addition, it has recently been noted that critically ill patients may have phagocytosis and behave as functionally immunosuppressed even prior to emergence of pneumonia (Afshari et al,2012) (37) . This effect is attributed from third day of intubation while the patient on mechanical ventilator which increase neutrophil phagocytic activity and phagocytosis by neutrophils (Rocha et al, 2013) (38) . Comparison of sputum color follow up as an indicator for(CPIS) results revealed that statistically significant differences between the two groups regarding sputum color only in the fifth day of the study.…”

“…The improvement of oral health status among the study group compared with the control group, reflects results of chest x-ray which is the best test for diagnosing pneumonia. Rocha et al, (2013) (38) assured that chest radiography with postero-anterior and lateral views is the preferred imaging examination for the evaluation of typical bacterial pneumonia. The study findings were in agreement with Sharma and Kaur (2012) (23) who reported that in most patients, radiographs demonstrate a patchy bronchopneumonic pattern, but segmental and lobar infiltration may be seen.…”

“…It was found that more than one half of the control group had sticky yellow and green secretions compared with less than one quarter of study group, which could explain the hindering effect of oral care intervention on patient outcome. (Rocha et al, 2013) (38) who stated that the sputum sample is checked for blood as well as color and consistency. If the sputum is green, sticky yellow or brown it reflects the existence of an infection.…”