help button home button
AJRCCM
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by TROUILLET, J.-L.
Right arrow Articles by GIBERT, C.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by TROUILLET, J.-L.
Right arrow Articles by GIBERT, C.

Am. J. Respir. Crit. Care Med., Volume 157, Number 2, February 1998, 531-539

Ventilator-associated Pneumonia Caused by Potentially Drug-resistant Bacteria

JEAN-LOUIS TROUILLET, JEAN CHASTRE, ALBERT VUAGNAT, MARIE-LAURE JOLY-GUILLOU, DANIÈLE COMBAUX, MARIE-CHRISTINE DOMBRET, and CLAUDE GIBERT

Réanimation Médicale, and Laboratoire de Bactériologie, Hôpital Bichat, Paris, France

To determine risk factors for ventilator-associated pneumonia (VAP) caused by potentially drug-resistant bacteria such as methicillin-resistant Staphylococcus aureus, Pseudomonas aeruginosa, Acinetobacter baumannii, and/or Stenotrophomonas maltophilia, 135 consecutive episodes of VAP observed in a single ICU over a 25-mo period were prospectively studied. For all patients, VAP was diagnosed based on results of bronchoscopic protected specimen brush (>=  103 cfu/ml) and bronchoalveolar lavage (>=  104 cfu/ml) specimens. Seventy-seven episodes were caused by "potentially resistant" bacteria and 58 episodes were caused by "other" organisms. According to logistic regression analysis, three variables among potential factors remained significant: duration of mechanical ventilation (MV) >=  7 d (odds ratio [OR] = 6.0), prior antibiotic use (OR = 13.5), and prior use of broad-spectrum drugs (third-generation cephalosporin, fluoroquinolone, and/or imipenem) (OR = 4.1). Distribution of the 245 causative bacteria was analyzed according to four groups defined by prior duration of MV (< 7 or >=  7 d) and prior use or lack of use (within 15 d) of antibiotics. Although 22 episodes of early-onset VAP in patients receiving no prior antibiotics were caused by antibiotic-susceptible bacteria, 84 episodes of late-onset VAP in patients receiving prior antibiotics were mainly caused by potentially resistant bacteria. Differences in the potential efficacies (ranging from 100% to 11%) against microorganisms of 15 antimicrobial regimens were studied according to classification into these four groups. These findings may provide a more rational basis for selecting the initial therapy of patients suspected of having VAP.




This article has been cited by other articles:


Home page
 JAMAHome page
J. Chastre, M. Wolff, J.-Y. Fagon, S. Chevret, F. Thomas, D. Wermert, E. Clementi, J. Gonzalez, D. Jusserand, P. Asfar, et al.
Comparison of 8 vs 15 Days of Antibiotic Therapy for Ventilator-Associated Pneumonia in Adults: A Randomized Trial
JAMA, November 19, 2003; 290(19): 2588 - 2598.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
J. Rello, D. A. Ollendorf, G. Oster, M. Vera-Llonch, L. Bellm, R. Redman, and M. H. Kollef
Epidemiology and Outcomes of Ventilator-Associated Pneumonia in a Large US Database
Chest, December 1, 2002; 122(6): 2115 - 2121.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
M. Iregui, S. Ward, G. Sherman, V. J. Fraser, and M. H. Kollef
Clinical Importance of Delays in the Initiation of Appropriate Antibiotic Treatment for Ventilator-Associated Pneumonia*
Chest, July 1, 2002; 122(1): 262 - 268.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
A. Combes, C. Figliolini, J.-L. Trouillet, N. Kassis, M. Wolff, C. Gibert, and J. Chastre
Incidence and Outcome of Polymicrobial Ventilator-Associated Pneumonia*
Chest, May 1, 2002; 121(5): 1618 - 1623.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
J. Chastre and J.-Y. Fagon
Ventilator-associated Pneumonia
Am. J. Respir. Crit. Care Med., April 1, 2002; 165(7): 867 - 903.
[Abstract] [Full Text] [PDF]

Home page
 ThoraxHome page
S Ewig, T Bauer, and A Torres
The pulmonary physician in critical care * 4: Nosocomial pneumonia
Thorax, April 1, 2002; 57(4): 366 - 371.
[Abstract] [Full Text] [PDF]

Home page
 J Antimicrob ChemotherHome page
H. Giamarellou
Prescribing guidelines for severe Pseudomonas infections
J. Antimicrob. Chemother., February 1, 2002; 49(2): 229 - 233.
[Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
J. HAYON, C. FIGLIOLINI, A. COMBES, J.-L. TROUILLET, N. KASSIS, M. C. DOMBRET, C. GIBERT, and J. CHASTRE
Role of Serial Routine Microbiologic Culture Results in the Initial Management of Ventilator-associated Pneumonia
Am. J. Respir. Crit. Care Med., January 1, 2002; 165(1): 41 - 46.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
P. E. Marik and J. Varon
Ventilator-Associated Pneumonia : Science and Hocus-Pocus
Chest, September 1, 2001; 120(3): 702 - 704.
[Full Text] [PDF]

Home page
 ChestHome page
J. Rello, J. A. Paiva, J. Baraibar, F. Barcenilla, M. Bodi, D. Castander, H. Correa, E. Diaz, J. Garnacho, M. Llorio, et al.
International Conference for the Development of Consensus on the Diagnosis and Treatment of Ventilator-Associated Pneumonia
Chest, September 1, 2001; 120(3): 955 - 970.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
E. H. Ibrahim, L. Tracy, C. Hill, V. J. Fraser, and M. H. Kollef
The Occurrence of Ventilator-Associated Pneumonia in a Community Hospital : Risk Factors and Clinical Outcomes
Chest, August 1, 2001; 120(2): 555 - 561.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
D. Pittet, P. Eggimann, and B. Rubinovitch
Prevention of Ventilator-associated Pneumonia by Oral Decontamination . Just Another SDD Study?
Am. J. Respir. Crit. Care Med., August 1, 2001; 164(3): 338 - 339.
[Full Text] [PDF]

Home page
 ChestHome page
G. D. Campbell Jr.
Top Ten List in Pneumonia
Chest, May 1, 2001; 119(5): 1563 - 1564.
[Full Text] [PDF]

Home page
 ChestHome page
J. P. Lynch III
Hospital-Acquired Pneumonia : Risk Factors, Microbiology, and Treatment
Chest, February 1, 2001; 119 (2009): 373S - 384S.
[Abstract] [Full Text] [PDF]

Home page
 ThoraxHome page
A Torres, T T Bauer, C León-Gil, F Castillo, F Alvarez-Lerma, A Martínez-Pellús, S R Leal-Noval, P Nadal, M Palomar, J Blanquer, et al.
Treatment of severe nosocomial pneumonia: a prospective randomised comparison of intravenous ciprofloxacin with imipenem/cilastatin
Thorax, December 1, 2000; 55(12): 1033 - 1039.
[Abstract] [Full Text]

Home page
 Am. J. Respir. Crit. Care Med.Home page
F. BLOT, B. RAYNARD, E. CHACHATY, C. TANCRÈDE, S. ANTOUN, and G. NITENBERG
Value of Gram Stain Examination of Lower Respiratory Tract Secretions for Early Diagnosis of Nosocomial Pneumonia
Am. J. Respir. Crit. Care Med., November 1, 2000; 162(5): 1731 - 1737.
[Abstract] [Full Text]

Home page
 ChestHome page
E. H. Ibrahim, G. Sherman, S. Ward, V. J. Fraser, and M. H. Kollef
The Influence of Inadequate Antimicrobial Treatment of Bloodstream Infections on Patient Outcomes in the ICU Setting
Chest, July 1, 2000; 118(1): 146 - 155.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
P. MARKOWICZ, M. WOLFF, K. DJEDAÏNI, Y. COHEN, J. CHASTRE, C. DELCLAUX, J. MERRER, B. HERMAN, B. VEBER, A. FONTAINE, et al.
Multicenter Prospective Study of Ventilator-Associated Pneumonia During Acute Respiratory Distress Syndrome . Incidence, Prognosis, and Risk Factors
Am. J. Respir. Crit. Care Med., June 1, 2000; 161(6): 1942 - 1948.
[Abstract] [Full Text]

Home page
 ChestHome page
E. H. Ibrahim, S. Ward, G. Sherman, and M. H. Kollef
A Comparative Analysis of Patients With Early-Onset vs Late-Onset Nosocomial Pneumonia in the ICU Setting
Chest, May 1, 2000; 117(5): 1434 - 1442.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
R. G. Wunderink
Prevention of Ventilator-Associated Pneumonia : Does One Size Fit All?
Chest, November 1, 1999; 116(5): 1155 - 1156.
[Full Text] [PDF]

Home page
 ThoraxHome page
T. T Bauer and A. Torres
Acute respiratory distress syndrome and nosocomial pneumonia
Thorax, November 1, 1999; 54(11): 1036 - 1040.
[Full Text]

Home page
 Am. J. Respir. Crit. Care Med.Home page
J. RELLO, M. SA-BORGES, H. CORREA, S.-R. LEAL, and J. BARAIBAR
Variations in Etiology of Ventilator-associated Pneumonia across Four Treatment Sites . Implications for Antimicrobial Prescribing Practices
Am. J. Respir. Crit. Care Med., August 1, 1999; 160(2): 608 - 613.
[Abstract] [Full Text]

Home page
 ChestHome page
J. Rello
Acinetobacter baumannii Infections in the ICU : Customization is the Key
Chest, May 1, 1999; 115(5): 1226 - 1229.
[Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
D. K. HEYLAND, D. J. COOK, L. GRIFFITH, S. P. KEENAN, and C. BRUN-BUISSON
The Attributable Morbidity and Mortality of Ventilator-Associated Pneumonia in the Critically Ill Patient
Am. J. Respir. Crit. Care Med., April 1, 1999; 159(4): 1249 - 1256.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
M. H. Kollef, G. Sherman, S. Ward, and V. J. Fraser
Inadequate Antimicrobial Treatment of Infections: A Risk Factor for Hospital Mortality Among Critically Ill Patients
Chest, February 1, 1999; 115(2): 462 - 474.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
M. H. Kollef
Antimicrobial Therapy of Ventilator-Associated Pneumonia : How To Select an Appropriate Drug Regimen
Chest, January 1, 1999; 115(1): 8 - 11.
[Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
D. L. GEORGE, P. S. FALK, R. G. WUNDERINK, K. V. LEEPER Jr., G. U. MEDURI, E. L. STEERE, C. E. CORBETT, and C. GLEN MAYHALL
Epidemiology of Ventilator-acquired Pneumonia Based on Protected Bronchoscopic Sampling
Am. J. Respir. Crit. Care Med., December 1, 1998; 158(6): 1839 - 1847.
[Abstract] [Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Proc. Am. Thorac. Soc. Am. J. Respir. Cell Mol. Biol.
Copyright © 1998 American Thoracic Society 		  SOTA, FL