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Ventilator-associated pneumonia in a tertiary hospital's polyvalent intensive care unit: a sixteen-month study

Abstract number: R2282

Kydona C., Pappas P., Avgousti D., Giasnetsova T., Tsiotras C., Gritsi-Gerogianni N.

Objectives: ICU is an area of elevated nosocomial infection rates. In our polyvalent 10-bed Unit of a tertiary care hospital Ventilator-associated pneumonia (VAP) is the second more frequent infection, complicating a high percentage of mechanically ventilated patients. Our aim was to study the incidence and outcome of VAP as well as the trends of the infective flora.

Methods: We studied all patients who were hospitalised above 72 hours in our ICU during the last 16 months. Protected bronchial samples of all patients with suspected VAP were taken and cultured and standard diagnostic criteria were followed.

Results: 341 patients were hospitalised from 1st August 2006 until 1st December 2007 in our ICU. 118 patients were excluded due to length of stay (LOS) less than 72 hours. 223 patients were studied and 42 were proved to suffer of VAP. Mean age was 55.09±18.57 years, male/female ratio was 33/9, mean APACHE II score was 23.8±5.63, and average LOS was 25.7±10.84 days. 44 episodes of VAP were recorded, two of them being of double pathogen cause and 7 had concomitant bacteraemia. The mean VAP onset day was 12.25±6.6 days. The most prevalent pathogens were Gram-negative bacteria: Acinetobacter baumannii 19 (42.2%), Pseudomonas aeruginosa 18 (40%), Klebsiella pneumoniae 4 (8.8%), Stenotrophomonas maltophilia 2 (4.4%) and of Gram-positive cocci only Staphylococcus aureus 2 (4.4%). The incidence of late VAP due to MDR Gram-negative pathogens was 28 (63.6%) and 6 of them (13.6%) were sensitive only to colimycin. The sensitivities are presented in the table. Positive outcome was found in 26 patients (61.9%) and was reversely related to APACHE II score, LOS and MODS.

Conclusion: Even though the percentage of MDR pathogens was high, the survival rate was fairly good. Colimycin is still 100% efficient on MDR Gram-negative pathogens, given both intravenously and aerosolised for the treatment of VAP, and remains our only constant ally.

Session Details

Date: 19/04/2008
Time: 00:00-00:00
Session name: 18th European Congress of Clinical Microbiology and Infectious Diseases
Subject:
Location: Barcelona, Spain
Presentation type:
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