Ventilator-associated pneumonia (VAP) due to susceptible only to colistin microorganisms

¹ Hospital Profesor Alejandro Posadas, Critical Care Service, Haedo, Buenos Aires, Argentina
² Hospital de Clínicas, Pulmonary and Critical Care Divisions, Universidad de Buenos Aires, Buenos Aires, Argentina
³ Hospital Higa Eva Perón, Critical Care Service, San Martín, Buenos Aires, Argentina

^* To whom correspondence should be addressed. E-mail: cymluna{at}fmed.uba.ar.

	Abstract

Acinetobacter species and Pseudomonas aeruginosa are common pathogens of ventilator-associated pneumonia (VAP). Presentation and outcome of VAP due to Acinetobacter spp. and P. aeruginosa susceptible to carbapenems (imipenem and/or meropenem) (Carb-S) and those susceptible only to colistin (Col-S), were compared in this retrospective study in 3 intensive care units (ICUs). Sixty one episodes of VAP caused by Acinetobacter spp. or Pseudomonas aeruginosa were studied, 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 later onset and previous episode of VAP, >10 days of prior antimicrobials and previous therapy with carbapenems during the present admission were more frequent in patients with Col-S strains. On multivariate analysis, >10 days of prior antimicrobials and previous episode of VAP remained significantly associated with Col-S VAP. Forty one percent of infections caused by Col-S isolates but no one of those due to Carb-S isolates had received prior carbapenem therapy. Col-S VAP episodes can be effectively treated using colistin without significant renal disfunction; this susceptibility pattern could be suspected in patients with previous VAP episode or prior antibiotic therapy >10 days preceding the present VAP episode.

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