Publication details
Pneumonie spojené se zdravotní péčí u pacientů v intenzivní péči - optimální nastavení iniciální empirické antimikrobiální terapie: výsledky multicentrické observační studie
| Title in English | Healthcare associated pneumonia in intensive care patients - optimal choice of initial empirical antimicrobial therapy: Results of a multicenter, observational study |
|---|---|
| Authors | |
| Year of publication | 2017 |
| Type | Article in Periodical |
| Magazine / Source | Anesteziologie a intenzivní medicína |
| MU Faculty or unit | |
| Citation | |
| Web | https://www.prolekare.cz/casopisy/anesteziologie-intenzivni-medicina/2017-3/pneumonie-spojene-se-zdravotni-peci-u-pacientu-v-intenzivni-peci-optimalni-nastaveni-inicialni-empiricke-antimikrobialni-terapie-vysledky-multicentricke-observacni-studie-61366 |
| Keywords | nosocomial infections; hospital acquired pneumonia; initial empirical antibiotic therapy; epidemiology; pneumonia |
| Description | Objective: This study aimed to obtain recent epidemiological data on hospital-acquired pneumonia (HAP) in intensive care patients and to determine adequate empirical antimicrobial therapy. Setting: Department of Anaesthesiology, Resuscitation and Intensive Care Medicine. Patients and methods: The prospective, multicenter, observational study assessed the spectrum of detected bacterial pathogens and their resistance to antimicrobial agents. It was compared with a reference approach to initial antibiotic therapy in early-and late-onset HAP. Results: Total 317 patients were included in the study. The final patient sample comprised 201 subjects (159 males and 42 females) with a mean age of 59.9 years. Total 260 valid samples of lower respiratory tract secretions were obtained. Early-and late-onset HAP was detected in 26 (12.9%) and 175 (87.1%) patients, respectively. A total of 22 bacterial species were identified as etiological agents, with detection rates higher that 5% being noted in only 6 of them (Klebsiella pneumoniae 20.4%, Pseudomonas aeruginosa 20.0%, Escherichia coli 10.8%, Enterobacter spp. 8.1%, Staphylococcus aureus 6.2% and Burkholderia cepacia complex 5.8%). Gram-negative bacteria were most prevalent (86.1%). Patients with early-onset HAP had considerably higher prevalence of strains of Staphylococcus aureus (26.9%) and Haemophilus influenzae (15.4%). In late-onset HAP, most dominant were the strains of Pseudomonas aeruginosa (21.8%) and Klebsiella pneumoniae (21.4%). Most pathogens causing HAP (74.0%) were shown to have a unique restriction profile. Adequate initial empirical antibiotic therapy was noted in 59.7% of patients. Conclusion: The reference approach to initial empirical antibiotic therapy of early-and late-onset HAP was consistent with the spectrum of bacterial pathogens and their susceptibility to antimicrobial agents. |