Journal ArticleDOI
Bacteremia and Ventilator-Associated Pneumonia: A Marker for Contemporaneous Extra-Pulmonic Infection
Anastasia Kunac,Ziad C. Sifri,Alicia M. Mohr,Helen Horng,Robert F. Lavery,David H. Livingston +5 more
TLDR
Trauma patients with B-VAP have a similar mortality but greater morbidity than those with VAP alone, and the number of units of red blood cell concentrates received is the most significant risk factor for developing B- VAP.Abstract:
Background: Ventilator-associated pneumonia (VAP) is a well-known complication of mechanical ventilation in severely injured patients. A subset of patients with VAP develop an associated bacteremia (B-VAP), but the risk factors, microbiology, morbidity, and mortality in this group are not well described. The goal of this study was to examine the incidence, predictors, and outcome of B-VAP in adult trauma patients. Methods: We conducted a retrospective review of trauma patients who developed VAP or B-VAP from January 2007 to December 2009 at a single, university-affiliated medical center. Ventilator-associated pneumonia was defined as a clinician-documented instance of VAP together with confirmed positive respiratory cultures (bronchoalveolar lavage [BAL] fluid specimen with ≥104 colony forming units (CFU)/mL or tracheal aspirate with moderate-to-many organisms and polymorphonuclear neutrophils [PMN]). Bacteremia associated with VAP (B-VAP) was defined as the blood culture of an organism that matc...read more
Citations
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Journal ArticleDOI
Management of Adults With Hospital-acquired and Ventilator-associated Pneumonia: 2016 Clinical Practice Guidelines by the Infectious Diseases Society of America and the American Thoracic Society
Andre C. Kalil,Mark L. Metersky,Michael Klompas,John Muscedere,Daniel A. Sweeney,Lucy B. Palmer,Lena M. Napolitano,Naomi P. O'Grady,John G. Bartlett,Jordi Carratalà,Ali A. El Solh,Santiago Ewig,Paul D. Fey,Thomas M. File,Marcos I. Restrepo,Jason A. Roberts,Jason A. Roberts,Grant W. Waterer,Peggy E. Cruse,Shandra L Knight,Jan Brozek +20 more
TL;DR: These guidelines are intended for use by healthcare professionals who care for patients at risk for hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP), including specialists in infectious diseases, pulmonary diseases, critical care, and surgeons, anesthesiologists, hospitalists, and any clinicians and healthcare providers caring for hospitalized patients with nosocomial pneumonia.
Journal ArticleDOI
Bloodstream infections in the Intensive Care Unit
TL;DR: The choice of the empiric antibiotic regimen is often challenging, due to the worldwide spread of multi-drug resistant organisms with reduced susceptibility to the available broad-spectrum antimicrobials.
Journal ArticleDOI
Does This Patient Need Blood Cultures? A Scoping Review of Indications for Blood Cultures in Adult Nonneutropenic Inpatients.
Valeria Fabre,Sima L Sharara,Alejandra B Salinas,Karen C. Carroll,Sanjay V. Desai,Sara E. Cosgrove +5 more
TL;DR: Routine BCx are recommended in syndromes with a high likelihood of bacteremia and those with moderate likelihood when cultures from the primary source of infection are unavailable or prompt initiation of antibiotics is needed prior to obtaining primary source cultures.
Journal ArticleDOI
Aetiology of hospital-acquired pneumonia and trends in antimicrobial resistance.
TL;DR: The development and introduction of rapid point-of-care diagnostics may improve understanding of the cause, antimicrobial resistance, diagnosis and treatment of HAP and VAP and encapsulate recent developments and concepts in this rapidly moving field.
Journal ArticleDOI
World-wide variation in incidence of Acinetobacter associated ventilator associated pneumonia: a meta-regression
James C. Hurley,James C. Hurley +1 more
TL;DR: There is greater than fivefold variation in Acinetobacter associated VAP among reports from various geographic regions worldwide and this variation is not explainable by variations in rates of VAP overall, admissions for trauma, year of publication and reporting practices as group level variables.
References
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Journal ArticleDOI
National Nosocomial Infections Surveillance (NNIS) System Report, data summary from January 1992 through June 2003, issued August 2003.
Journal ArticleDOI
Nosocomial pneumonia in ventilated patients: A cohort study evaluating attributable mortality and hospital stay
TL;DR: Pneumonias occurring in ventilated patients, especially those due to Pseudomonas or Acinetobacter species, are associated with considerable mortality in excess of that resulting from the underlying disease alone, and significantly prolong the length of stay in the intensive care unit.
Journal ArticleDOI
Clinical and economic consequences of ventilator-associated pneumonia: a systematic review.
TL;DR: Ventilator-associated pneumonia occurs in a considerable proportion of patients undergoing mechanical ventilation and is associated with substantial morbidity, a two-fold mortality rate, and excess cost, and strategies that effectively prevent VAP are urgently needed.
Journal ArticleDOI
Impact of BAL data on the therapy and outcome of ventilator-associated pneumonia
Carlos M. Luna,Patricia Vujacich,Michael S. Niederman,Carlos Vay,Carlos R Gherardi,Josue Matera,Enrique C. Jolly +6 more
TL;DR: The impact of BAL data on the selection of antibiotics and the outcomes of patients with ventilator-associated pneumonia (VAP) is defined and mortality rate is reduced if this empiric therapy is adequate, compared to when this therapy is inadequate or no therapy is given.
Journal ArticleDOI
Community-acquired Klebsiella pneumoniae bacteremia: global differences in clinical patterns.
Wen Chien Ko,David L. Paterson,Anthanasia J. Sagnimeni,Dennis S. Hansen,Anne von Gottberg,Sunita Mohapatra,Jose Maria Casellas,Herman Goossens,Lutfiye Mulazimoglu,Gordon M. Trenholme,Keith P. Klugman,Joseph G. McCormack,Victor L. Yu +12 more
TL;DR: A distinctive form of K. pneumoniae infection, often causing liver abscess, was identified, almost exclusively in Taiwan.
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