Surveillance cultures in intensive care units: A nationwide survey on current practice providing future perspectives

Scholte, Johannes B. J.; Mook, Walther N. K. A. van; Linssen, Catharina F. M.; Dessel, Helke A. van; Bergmans, Dennis C. J. J.; Savelkoul, Paul H. M.; Roekaerts, P. M. H. J.

doi:10.1016/j.jcrc.2014.05.018

Cited by 2 publications

(2 citation statements)

References 23 publications

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“…The usefulness of systematic ETA cultures in adults and PICU patients is an age-old debate. [22][23][24] Nevertheless, the relationship between bronchial colonization and pneumonia is established in resuscitation patients. A bronchial sample taken for less than 3 days predicts the germ responsible for pneumonia in 63-83% of cases, according to the literature on adult intensive care units (ICUs).…”

Section: Discussionmentioning

confidence: 99%

Systematic Endotracheal Aspiration in the Pediatric Intensive Care Unit Reduces Broad-spectrum Antibiotic Use for Ventilator-associated Pneumonia

Roncin

Vanel

Morand

et al. 2022

Pediatric Infectious Disease Journal

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Aim: To determine the impact of a systematic endotracheal aspiration (ETA) sampling program for mechanically ventilated patients on initial antibiotic therapy for ventilator-acquired pneumonia (VAP). Design: Retrospective cohort study; before-after study design. Setting: Pediatric intensive care unit (PICU) with 16 medical and surgical beds in a tertiary teaching hospital. Subjects: Patients <16 years of age hospitalized in the PICU who fulfilled VAP criteria. Intervention: Biweekly systematic ETA sampling was conducted in mechanically ventilated patients. Measurements: We retrospectively studied patients who received antibiotic therapy for suspected VAP 12 months before and after the initiation of systematic ETA (periods 1 and 2, respectively), evaluating the initial antibiotic therapy spectrum in both periods. Results: During period 1, 56 patients developed VAP and 47 developed VAP during period 2. The incidence was 17 cases of VAP/1000 days of mechanical ventilation in both periods. Ideal antibiotic therapy was prescribed in 19.6% of cases for period 1 and 55.2% for period 2 (P = 0.001). Initial antibiotic therapy for VAP during period 2 had a significantly lower proportion of broad-spectrum antibiotics than therapy during period 1 (P = 0.01). Conclusion: In our PICU, knowledge of bronchial colonization reduced initial broad-spectrum antibiotic use for VAP.

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Section: Discussionmentioning

confidence: 99%

Systematic Endotracheal Aspiration in the Pediatric Intensive Care Unit Reduces Broad-spectrum Antibiotic Use for Ventilator-associated Pneumonia

Roncin

Vanel

Morand

et al. 2022

Pediatric Infectious Disease Journal

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“…Additionally, antibiotic guidance by surveillance cultures in a hypothetic model of 223 hospital-acquired pneumonia patients resulted in the use of a smaller number of broad-spectrum antibiotics without reducing appropriateness [ 16 ]. Because clinicians aim to target these previously identified microorganisms in the case where pneumonia develops [ 17 ], one could hypothesise that the results of antibiotic susceptibility of these ETA cultures could be useful to analyse the general appropriateness of empirical antibiotics.…”

Section: Introductionmentioning

confidence: 99%

Empirical antibiotic therapy for pneumonia in intensive care units: a multicentre, retrospective analysis of potentially pathogenic microorganisms identified by endotracheal aspirates cultures

Scholte

Duong

Linssen

et al. 2015

Eur J Clin Microbiol Infect Dis

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The purpose of this investigation was to explore the presumed relationship between the days of hospitalisation and microorganisms identified by endotracheal aspirate cultures in relation to adequate empirical treatment strategies of pneumonia in the intensive care unit (ICU). All potentially pathogenic microorganisms identified by (surveillance) cultures of endotracheal aspirates obtained in the ICUs of two Dutch teaching hospitals in 2007 and 2012 were retrospectively collected and analysed. Antibiotic susceptibilities to 11 antibiotics were calculated for several time points (days or weeks) after hospital admission and expressed per patient-day. In total, 4184 potentially pathogenic microorganisms identified in 782 patients were analysed. Prevalence of the classic early-onset pneumonia-causing microorganisms decreased from 55 % on the first four days to 34 % on days 4–6 after hospital admission (p < 0.0001). Susceptibility to amoxicillin/clavulanic acid was below 70 % on all days. Except for days 0 and 12, susceptibility to ceftriaxone was below 80 %. The overall susceptibility to piperacillin/tazobactam was 1518/1973 (77 %) in 2007 vs. 727/1008 (67 %) in 2012 (p < 0.0001). After day 8 of hospital admission, susceptibility to piperacillin/tazobactam therapy was below 80 % in 2012. After one week of hospital admission, susceptibilities to antibiotics were lower in the hospital that included that antibiotic in the local empirical treatment protocols as compared to the hospitals in which that antibiotic was not or infrequently included: 90/434 (21 %) vs. 117/398 (29 %); p = 0.004 for amoxicillin/clavulanic acid and 203/433 (47 %) vs. 253/398 (64 %); p < 0.001 for ceftriaxone. No cut-off in the number of days after hospital admission could be identified to distinguish early-onset from late-onset pneumonia. Consequently, the choice of empirical antibiotics should probably not be based on the time of onset.Electronic supplementary materialThe online version of this article (doi:10.1007/s10096-015-2482-y) contains supplementary material, which is available to authorized users.

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Surveillance cultures in intensive care units: A nationwide survey on current practice providing future perspectives

Cited by 2 publications

References 23 publications

Systematic Endotracheal Aspiration in the Pediatric Intensive Care Unit Reduces Broad-spectrum Antibiotic Use for Ventilator-associated Pneumonia

Systematic Endotracheal Aspiration in the Pediatric Intensive Care Unit Reduces Broad-spectrum Antibiotic Use for Ventilator-associated Pneumonia

Empirical antibiotic therapy for pneumonia in intensive care units: a multicentre, retrospective analysis of potentially pathogenic microorganisms identified by endotracheal aspirates cultures

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