RT Journal Article
SR Electronic
T1 Ventilator-associated pneumonia due to colistin susceptible-only microorganisms
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 307
OP 313
DO 10.1183/09031936.00156906
VO 30
IS 2
A1 Rios, F. G.
A1 Luna, C. M.
A1 Maskin, B.
A1 Valiente, A. Saenz.
A1 Lloria, M.
A1 Gando, S.
A1 Sosa, C.
A1 Baquero, S.
A1 Llerena, C.
A1 Petrati, C.
A1 Apezteguia, C.
YR 2007
UL http://erj.ersjournals.com/content/30/2/307.abstract
AB 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.