To clarify the clinical features of
nosocomial pneumonia during
mechanical ventilation (
ventilator-associated pneumonia) and to select the appropriate
antibiotic therapy for patients, we performed a clinical analysis of 19 patients (26 episodes) with this condition. The following results were obtained. 1, The average age of the patients was 68 years old (male 16, female 3). 2, VAP occurred three times in 2 cases, twice in 3 cases, and once in 14 cases. 3, The duration of
mechanical ventilation was from 7 days to 11 years and 5 months (the average was 2.1 years). 4, The microorganism isolated from the aspiration sputum of the VAP patients was Pseudomonas aeruginosa frequently, but it was difficult to determine whether this microorganism was the causative microorganism. Ten strains of Staphylococcus aureus (MRSA seven strains and MSSA three strains) were newly isolated at the same time as VAP and especially in the cases in which these were thought to be causative microrganisms, all the patients died within a short time. 5,
Antibiotics were clinically effective for 53.8% of all the VAP patients and
carbapenem antibiotics (for example, IPM/CS) were also used for the effective group. 6, Regarding the risk factors for VAP, factors such as the duration of
mechanical ventilation, the existence of
chronic obstructive pulmonary disease, a hyponutritional state, prior
antibiotics, aspiration of gastric contents, histamine-type-2 receptor antagonist, and
multiple organ failure showed significant differences and were suspected to be associated with the appearance of VAP.