Mortality Due to Ventilator-Associated Pneumonia or Colonization with Pseudomonas or Acinetobacter Species: Assessment by Quantitative Culture of Samples Obtained by a Protected Specimen Brush

Ventilator-associated pneumonia (VAP) due to multiresistant pathogens is associated with a high death rate. We analyzed the relationship between VAP due to Pseudomonas or Acinetobacter species and death by comparing the outcomes for patients colonized with these pathogens (bacterial counts of < 1...

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Bibliographic Details
Published in:Clinical infectious diseases 1996-09, Vol.23 (3), p.538-542
Main Authors: Fagon, Jean-Yves, Chastre, Jean, Domart, Yves, Trouillet, Jean-Louis, Gibert, Claude
Format: Article
Language:English
Subjects:
Acinetobacter
Acinetobacter - drug effects
Acinetobacter - pathogenicity
Aged
Bacterial diseases
Bacterial diseases of the respiratory system
Bacterial load
Bacterial pneumonia
Biological and medical sciences
Clinical Articles
Drug Resistance, Microbial
Female
Human bacterial diseases
Humans
Infections
Infectious diseases
Intensive Care Units
Male
Medical sciences
Middle Aged
Mortality
Pathogens
Pneumonia
Pneumonia, Bacterial - etiology
Pneumonia, Bacterial - mortality
Pneumonia, Bacterial - therapy
Pseudomonas
Pseudomonas - drug effects
Pseudomonas - pathogenicity
Respiration, Artificial - adverse effects
Respiration, Artificial - mortality
Ventilator associated pneumonia
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Summary:Ventilator-associated pneumonia (VAP) due to multiresistant pathogens is associated with a high death rate. We analyzed the relationship between VAP due to Pseudomonas or Acinetobacter species and death by comparing the outcomes for patients colonized with these pathogens (bacterial counts of < 103 cfu/mL) with those for patients with pneumonia due to these pathogens (bacterial counts of ⩾ 103 cfu/mL). Samples were obtained systematically with a protected specimen brush when pneumonia was suspected. Clinical characteristics at admission to our intensive care unit and clinical features at the time of suspicion of VAP were not significantly different between colonized patients and those with VAP. Mortality rates were 29% among colonized patients and 73% among patients with VAP (P < .001). These results demonstrate a relationship between a high mortality rate and the development of pneumonia due to multiresistant, nonfermenting, gram-negative bacilli (⩾ 103 cfu/mL) in the lower airways of patients receiving ventilatory support.
ISSN:1058-4838
1537-6591
DOI:10.1093/clinids/23.3.538