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Title of Journal: Intensive Care Med

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Abbravation: Intensive Care Medicine

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Springer-Verlag

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DOI

10.1016/j.bbcan.2008.12.004

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1432-1238

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Management of ventilatorassociated pneumonia in a

Authors: Kemal Agbaht Thiago Lisboa Angel Pobo Alejandro Rodriguez Alberto Sandiumenge Emili Diaz Jordi Rello
Publish Date: 2007/06/12
Volume: 33, Issue: 8, Pages: 1387-1395
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Abstract

VAP isolates in a multidisciplinary ICU documented by quantitative respiratory cultures and recorded in a 42month database were compared based on the presence or absence of trauma Causative microorganisms were classified in four groups based on mechanical ventilation duration  5 days and previous antibiotic exposure One hundred eightythree patients developed 196 episodes of VAP 98 trauma Methicillinsensitive Staphylococcus aureus MSSA was more frequent 345 vs 115 p  001 in trauma whereas methicillinresistant Staphylococcus aureus MRSA was more frequent 2 vs 115 p  001 in nontrauma No significant differences were found between trauma and nontrauma patients regarding prevalence of other microorganisms In trauma patients MSSA episodes were equally distributed between early and lateonset VAP 51 vs 49 but no MRSA episode occurred in the earlyonset groupTrauma influences the microbiology of pneumonia and it should be considered in the initial antibiotic regimen choice Our data demonstrate that patients with trauma had a higher prevalence of MSSA but the overall prevalence was sufficiently high to warrant S aureus coverage for both groups On the other hand since no MRSA was isolated during the first 10 days of mechanical ventilation on trauma patients MRSA coverage in these patients becomes necessary only 10 days after admission

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