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Introduction: Hospital-acquired pneumonia, especially ventilator-associated pneumonia (VAP), caused by methicillin resistant Staphylococcus aureus (MRSA) is considered among the important nosocomial infections. In the current guidelines, linezolid or vancomycin treatment is recommended in the empirical treatment of VAP when suspected from MRSA. Patients and Methods: In our retrospective study, we analyzed the patients that have been applied mechanical ventilation in the anesthesiology and reanimation, neurology, and neurosurgery intensive care units between October 2005 and January 2008. The patients were diagnosed as VAP evidenced by MRSA isolation from the endotracheal aspirate cultures. Results: Among the 32 patients, 3 of them died in the first 24 hours, and 2 of them succumbed to underlying diseases before the completion of treatment. Clinical improvement was observed in 48-72 hours in all of the 27 patients who completed 14-day linezolid treatment. Microbiological eradication was the case in 23 of 25 patients according to the endotracheal culture results obtained in the 48- 72 hours of treatment. When all the patients are taken into consideration, clinical success was the result in 84.4% of the patients, and microbiological eradication was 71.8%. Conclusion: In Turkey, the data about clinical experience of linezolid treatment in MRSA-VAP cases is very limited, and our study provides some data in this field. Our results suggest that linezolid is effective in the treatment of MRSA-VAP cases due to its high clinical and microbiological effectiveness, however, these observations need to be supported with well planned controlled clinical studies. |
