Ventilator-Associated Pneumonia in a Multi-Hospital System Differences in Microbiology by Location

Babcock, Hilary M.; Zack, Jeanne E.; Garrison, Teresa; Trovillion, Ellen; Kollef, Marin H.; Fraser, Victoria J.

doi:10.1086/502149

Cited by 54 publications

(42 citation statements)

References 27 publications

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“…The investigators used a cutoff value of 10 5 cfu/mL for differentiate between tracheobronchial colonization and infection. In contrast to these studies, a US study by Babcock et al 8 found that S. aureus (28.4% of isolates) was the predominant organism, followed by P. aeruginosa. It is believed that the differences in the etiologic agents of VAP found in different studies are the result of differences in the population of intensive care unit patients, duration of hospital stay, and prior antimicrobial therapy.…”

Section: Detection and Quantitation Of The Etiologic Agents Of Ventilmentioning

confidence: 83%

Detection and Quantitation of the Etiologic Agents of Ventilator-Associated Pneumonia in Endotracheal Tube Aspirates From Patients in Iran

Rahbar¹,

Hajia²

2006

Infect. Control Hosp. Epidemiol.

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Section: Detection and Quantitation Of The Etiologic Agents Of Ventilmentioning

confidence: 83%

Detection and Quantitation of the Etiologic Agents of Ventilator-Associated Pneumonia in Endotracheal Tube Aspirates From Patients in Iran

Rahbar¹,

Hajia²

2006

Infect. Control Hosp. Epidemiol.

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“…A retrospective cohort study of the microbiologic etiology of VAP in the ICU setting was performed in three hospital settings: a large teaching hospital, a community hospital, and a children's hospital (5). The most commonly isolated organisms were similar across adult and pediatric hospitals: Staphylococcus aureus (28.4%), Pseudomonas aeruginosa (25.2%), and other gramnegative bacilli (26.6%).…”

Section: Microbiologymentioning

confidence: 99%

Ventilator-Associated Pneumonia in Neonatal and Pediatric Intensive Care Unit Patients

2007

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SUMMARY Ventilator-associated pneumonia (VAP) is the second most common hospital-acquired infection among pediatric intensive care unit (ICU) patients. Empiric therapy for VAP accounts for approximately 50% of antibiotic use in pediatric ICUs. VAP is associated with an excess of 3 days of mechanical ventilation among pediatric cardiothoracic surgery patients. The attributable mortality and excess length of ICU stay for patients with VAP have not been defined in matched case control studies. VAP is associated with an estimated $30,000 in attributable cost. Surveillance for VAP is complex and usually performed using clinical definitions established by the CDC. Invasive testing via bronchoalveolar lavage increases the sensitivity and specificity of the diagnosis. The pathogenesis in children is poorly understood, but several prospective cohort studies suggest that aspiration and immunodeficiency are risk factors. Educational interventions and efforts to improve adherence to hand hygiene for children have been associated with decreased VAP rates. Studies of antibiotic cycling in pediatric patients have not consistently shown this measure to prevent colonization with multidrug-resistant gram-negative rods. More consistent and precise approaches to the diagnosis of pediatric VAP are needed to better define the attributable morbidity and mortality, pathophysiology, and appropriate interventions to prevent this disease.

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“…Pseudomonas aeruginosa is an important opportunistic pathogen responsible for nosocomial infections (2), burn infections (1,31), and chronic lung infections in cystic fibrosis (CF) patients (11). P. aeruginosa lung infections are difficult to eradicate in CF patients, even with intensive antibiotic treatment, probably due to the concurrent presence of multidrugresistant strains (5) and their biofilm mode of growth (11).…”

mentioning

confidence: 99%

Effects of Intratracheal Administration of Novispirin G10 on a Rat Model of Mucoid Pseudomonas aeruginosa Lung Infection

Song

Mygind

et al. 2005

Antimicrob Agents Chemother

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Chronic Pseudomonas aeruginosa lung infection is a major problem for patients with cystic fibrosis (CF). The biofilm mode of growth of the pathogen makes it highly resistant to antibiotic treatment, and this is especially pronounced with mucoid strains. In this study, novispirin G10, a synthetic antimicrobial peptide patterned loosely on sheep myeloid antimicrobial peptide 29, was tested in a rat model of mucoid P. aeruginosa lung infection. P. aeruginosa NH57388A, a mucoid strain isolated from a CF patient, was mixed with the alginate produced by the bacterium itself and adjusted to a concentration of 10 10 CFU/ml. Each rat received 10 9 CFU of bacteria intratracheally in the left lung to establish lung infection. At 0 and 3 h post P. aeruginosa infection, the treated group of rats received novispirin G10 (0.1 mg/ml, 0.1 ml/rat) intratracheally, whereas the control group received vehicle treatment only. The animals were sacrificed on days 3, 5, 7, and 10 after challenge for evaluation of various parameters. On day 5, 50% of the rats in the treated group had cleared the bacteria from the lungs, whereas in the control group, none of the rats cleared the pathogen (P < 0.03). The average bacterial loads remaining in the lungs of treated rats on days 3 and 5 were more than 170-and 330-fold lower than in the control groups (P < 0.0005 and P < 0.0003). In accordance, the macroscopic and microscopic lung pathology was also significantly milder in the treated group compared to the control group (P < 0.0002). Lung cytokine responses in the treated group were significantly lower than in the control group. The results suggest that novispirin G10 might be useful in treating antibiotic-resistant P. aeruginosa lung infections.

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Ventilator-Associated Pneumonia in a Multi-Hospital System Differences in Microbiology by Location

Cited by 54 publications

References 27 publications

Detection and Quantitation of the Etiologic Agents of Ventilator-Associated Pneumonia in Endotracheal Tube Aspirates From Patients in Iran

Detection and Quantitation of the Etiologic Agents of Ventilator-Associated Pneumonia in Endotracheal Tube Aspirates From Patients in Iran

Ventilator-Associated Pneumonia in Neonatal and Pediatric Intensive Care Unit Patients

Effects of Intratracheal Administration of Novispirin G10 on a Rat Model of Mucoid Pseudomonas aeruginosa Lung Infection

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