Jung B, Sebbane M, Chanques G, Courouble P, Cisse M, Perrigault PF, Jean-Pierre H, Eledjam JJ, Jaber S. Pneumonies acquises sous ventilation mécanique: suivez les recommandations!
ACTA ACUST UNITED AC 2007;
26:844-9. [PMID:
17698314 DOI:
10.1016/j.annfar.2007.06.012]
[Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2006] [Accepted: 06/21/2007] [Indexed: 11/27/2022]
Abstract
OBJECTIVES
To compare the clinical outcomes and the causative pathogens of early-onset and late-onset ventilator-associated pneumonia (VAP) diagnosed by bronchoalveolar lavage (BAL).
STUDY DESIGN
Prospective, observational, epidemiological study.
PATIENTS AND METHODS
During a 7-years period, all first episodes of VAP were prospectively included. Diagnosis was confirmed by a BAL with a threshold of 10(4) cfu/ml. Late-onset pneumonia was defined if occurred after the seventh day after mechanical ventilation.
RESULTS
One hundred and thirteen VAP were studied. Fifty were early-onsets and 63 late-onsets. Thirty-four per cent of early-onset VAP and 73% of late-onset VAP were due to potential multiresistants pathogens. Pseudomonas aeruginosa was the most commonly isolated bacteria both in early-onset and late-onset VAP (16 and 39% respectively). Morbidity and mortality (29 vs 29%, ns) were not statically different between the two groups (early-onset and late-onset VAP).
CONCLUSION
In our study, both early-onset and late-onset VAP were mainly caused by potentially multiresistants bacteria, most commonly Gram negative bacilli. Even for early VAP, clinicians should be aware about all risk factors for potentially multiresistants pathogens and not only the delay of onset of the VAP episode.
Collapse