Pseudomonas aeruginosa ventilator associated pneumonia: improved outcomes with earlier follow-up

Autor: Nikolaos Liratzopoulos, Konstantinos I. Manolas, Eleni Efraimidou, Elpis Giantsou, J. Duncan Young
Rok vydání: 2010
Předmět:
Zdroj: Health. :82-89
ISSN: 1949-5005
1949-4998
DOI: 10.4236/health.2010.22014
Popis: It is not clear what is the appropriate timing to follow-up patients with ventilator-associated pneumonia (VAP) and Clinical Pulmonary Infection Score >6 between days 3-5 of an appropriate antibiotic treatment. We studied 122 patients with Pseudomonas aeruginosa VAP. A follow-up respiratory sample was collected on days three or five (”day-three” and ”day-five” group) and treatment was modified 48h later. Molecular typing identified super-infections or persistence. For serial data another respiratory sample was collected, on day three from the ”day-five” group and on day five from the ”day-three” group. Sixty patients, in the ”daythree” group compared to 62 in the ”day-five” group, had reduced fourteen-day mortality (18.3% and 38.7%; p=0.01) and fewer days in intensive care unit (17.2 ± 4.3 compared to 27.3 ± 4.7, p<0.05). Eighteen patients of the ”dayfive” group were diagnosed with super-infection and 22 with persistence on day five, of whom 14 and 19 had been having these patterns since day three. For patients with Pseudomonas aeruginosa VAP and Clinical Pulmonary Infection Score >6, improved fourteen-day mortality and shorter duration of stay in health-care facilities were observed with earlier follow-up.
Databáze: OpenAIRE