Ventilator-associated pneumonia due to colistin susceptible-only microorganisms.

Abstract

Acinetobacter spp. and Pseudomonas aeruginosa are common pathogens of ventilator-associated pneumonia (VAP). The presentation and outcome of VAP due to Acinetobacter spp. and P. aeruginosa susceptible to carbapenems (Carb-S; imipenem and/or meropenem) and to colistin only (Col-S) were compared in the present retrospective study in three intensive care units. A total of 61 episodes of VAP caused by Acinetobacter spp. or P. aeruginosa were studied, of which 30 isolates were Carb-S and 31 were Col-S. Demographics, worsening of renal function and mortality were not different. The univariate analysis showed that a later onset and a previous episode of VAP, prior antimicrobial therapy for >10 days and previous therapy with carbapenems during the present admission were more frequent in patients with Col-S strains. On multivariate analysis, prior antimicrobial therapy for >10 days and a previous episode of VAP remained significantly associated with Col-S VAP. Approximately 41% of the infections caused by Col-S isolates, but none of those due to Carb-S isolates, had received prior carbapenem therapy. Colistin-susceptible ventilator-associated pneumonia episodes can be effectively treated using colistin without significant renal dysfunction. This susceptibility pattern could be suspected in patients with a previous ventilator-associated pneumonia episode or prior antibiotic therapy for >10 days preceding the present ventilator-associated pneumonia episode.

• Authors: F G Rios, C M Luna, B Maskin, A Saenz Valiente, M Lloria, S Gando, C Sosa, S Baquero, C Llerena, C Petrati, C Apezteguia
• Journal: The European respiratory journal (Eur Respir J) Vol. 30 Issue 2 Pg. 307-13 (Aug 2007) ISSN: 0903-1936 [Print] England
• PMID: 17504791 (Publication Type: Journal Article)

Chemical References

• Anti-Bacterial Agents
• Thienamycins
• Imipenem
• Meropenem
• Colistin

Topics

• Acinetobacter Infections (complications, drug therapy, microbiology)
• Analysis of Variance
• Anti-Bacterial Agents (therapeutic use)
• Chi-Square Distribution
• Colistin (therapeutic use)
• Drug Resistance, Microbial
• Female
• Humans
• Imipenem (therapeutic use)
• Male
• Meropenem
• Middle Aged
• Pneumonia (drug therapy, etiology, microbiology)
• Pseudomonas Infections (complications, drug therapy, microbiology)
• Pseudomonas aeruginosa (isolation & purification)
• Respiration, Artificial (adverse effects)
• Retrospective Studies
• Risk Factors
• Thienamycins (therapeutic use)
• Ventilators, Mechanical