A prospective study of antibiotic susceptibility in patients with ventilator associated pneumonia. | [Anaesthesia, Pain and Intensive Care • 2012]

Author(s):

1. Seyed Mohammad Reza Hashemian: Chronic Respiratory Disease Research Center, NRITLD, Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Clinical Tuberculosis and Epidemiology Research Center, NRITLD, Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran

2. Payam Tabarsi: Clinical Tuberculosis and Epidemiology Research Center, NRITLD, Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Mycobacteriology Research Center, NRITLD, Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran

3. Majid Malek Mohammad: Clinical Tuberculosis and Epidemiology Research Center, NRITLD, Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran

4. Majid Marjan: Clinical Tuberculosis and Epidemiology Research Center, NRITLD, Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran

5. Masoud Shamaei: Clinical Tuberculosis and Epidemiology Research Center, NRITLD, Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran

6. Seyed Alireza Nadji: Virology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran

7. Mandana Chitsazan: Chronic Respiratory Disease Research Center, NRITLD, Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran

8. Golnar Radmand: Chronic Respiratory Disease Research Center, NRITLD, Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran

9. Seyed Amir Mohajerani: Tracheal Disease Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran

10. Hamid Reza Jamaati: Chronic Respiratory Disease Research Center, NRITLD, Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Abstract:

Background: An outbreak of antibiotic resistant gram-negative bacteria, particularly Acinetobacter, in intensive care unit is of great importance for intensivists due to high mortality and low effective therapy. Objective: We aimed to evaluate antibiotic susceptibility of isolated gram-negatives from patients with ventilator- associated pneumonia (VAP) in ICU. Material and Methods: In a prospective, descriptive study, ICU patients who were under mechanical ventilation and had resistant ventilator-associated pneumonia (VAP) were evaluated for prevalence and antibiotic susceptibility of identified pathogens. The data, including clinical outcome and microbiological results were analyzed. Results: Fifteen ICU patients were included with mean age of 50.5 years (the range between 20-96 years). Median of hospitalization was 53 days (the range of 15 to 135 days), median of hospitalization before admission to ICU was 2.5 day (the range was from zero to 27 days), and median days of bacterial isolation was 18 days (the range of 5 to 30 days). Six patients (42.9%) patients were admitted in ICU after surgery, and 8 patients (57.1%) due to another medical problem. Acinetobacter was dominant isolated pathogen in VAP patients. Imipenem did better than other antibacterials against E. coli, Klebsiela, and Enterobacter, but Tazobactem did worse than imipenem against imipenem-resistant Acinetobacter (p = 0.032). Treatment outcome in 9 cases (50%) was death. No deaths after 28 days of follow-up were observed. Conclusion: It seems that, gram-negative pathogens are the main cause of morbidity and mortality in ICU admitted ventilator induced infection. Imipenem resistant Acinetobacter is among the most prevalent and difficult to treat pathogens in ICU, and needs special consideration for initial therapy.

Page(s): 31-37

DOI: DOI not available

Published: Journal: Anaesthesia, Pain and Intensive Care, Volume: 16, Issue: 1, Year: 2012

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