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Microbiology of ventilator-associated pneumonia compared with that of hospital-acquired pneumonia.

Publication ,  Journal Article
Weber, DJ; Rutala, WA; Sickbert-Bennett, EE; Samsa, GP; Brown, V; Niederman, MS
Published in: Infect Control Hosp Epidemiol
July 2007

OBJECTIVE: Nosocomial pneumonia is the leading cause of mortality attributed to nosocomial infection. Appropriate empirical therapy has been associated with improved survival, but data are limited regarding the etiologic agents of hospital-acquired pneumonia in nonventilated patients (HAP). This evaluation assessed whether the currently recommended empirical therapy is appropriate for both ventilator-associated pneumonia (VAP) and HAP by evaluating the infecting flora. DESIGN: Prospectively collected hospitalwide surveillance data was obtained by infection control professionals using standard Centers for Disease Control and Prevention definitions. SETTING: A tertiary care academic hospital. PATIENTS: All patients admitted from 2000 through 2003. RESULTS: A total of 588 episodes of pneumonia were reported in 556 patients: 327 episodes of VAP in 309 patients, and 261 episodes of HAP in 247 patients. The infecting flora in ventilated patients included gram-positive cocci (32.0% [oxacillin-susceptible Staphylococcus aureus {OSSA}, 9.25%; oxacillin-resistant Staphylococcus aureus {ORSA}, 17.75%]), gram-negative bacilli (59.0% (Pseudomonas aeruginosa, 17.50%; Stenotrophomonas maltophilia, 6.75%; Acinetobacter species, 7.75%), and miscellaneous pathogens (9.0%). The infecting flora in nonventilated patients included gram-positive cocci (42.59% [OSSA, 13.33%; ORSA, 20.37%]), gram-negative bacilli (39.63% [P. aeruginosa, 9.26%; S. maltophilia, 1.11%; Acinetobacter species, 3.33%), and miscellaneous pathogens (17.78%). CONCLUSIONS: Our data demonstrated that patients with HAP, compared with those with VAP, had a similar frequency of infection with ORSA but less commonly had infections due to P. aeruginosa, Acinetobacter species, and S. maltophilia. However, the overall frequency of infection with these pathogens was sufficiently high to warrant the use of empirical therapy likely to be active against them. Our data supports using the currently recommended empirical therapy for both HAP and VAP.

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Published In

Infect Control Hosp Epidemiol

DOI

ISSN

0899-823X

Publication Date

July 2007

Volume

28

Issue

7

Start / End Page

825 / 831

Location

United States

Related Subject Headings

  • Ventilators, Mechanical
  • Prospective Studies
  • Pneumonia, Ventilator-Associated
  • Pneumonia, Bacterial
  • Infection Control
  • Humans
  • Gram-Positive Bacteria
  • Gram-Negative Bacteria
  • Equipment Contamination
  • Epidemiology
 

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Weber, D. J., Rutala, W. A., Sickbert-Bennett, E. E., Samsa, G. P., Brown, V., & Niederman, M. S. (2007). Microbiology of ventilator-associated pneumonia compared with that of hospital-acquired pneumonia. Infect Control Hosp Epidemiol, 28(7), 825–831. https://doi.org/10.1086/518460
Weber, David J., William A. Rutala, Emily E. Sickbert-Bennett, Gregory P. Samsa, Vickie Brown, and Michael S. Niederman. “Microbiology of ventilator-associated pneumonia compared with that of hospital-acquired pneumonia.Infect Control Hosp Epidemiol 28, no. 7 (July 2007): 825–31. https://doi.org/10.1086/518460.
Weber DJ, Rutala WA, Sickbert-Bennett EE, Samsa GP, Brown V, Niederman MS. Microbiology of ventilator-associated pneumonia compared with that of hospital-acquired pneumonia. Infect Control Hosp Epidemiol. 2007 Jul;28(7):825–31.
Weber, David J., et al. “Microbiology of ventilator-associated pneumonia compared with that of hospital-acquired pneumonia.Infect Control Hosp Epidemiol, vol. 28, no. 7, July 2007, pp. 825–31. Pubmed, doi:10.1086/518460.
Weber DJ, Rutala WA, Sickbert-Bennett EE, Samsa GP, Brown V, Niederman MS. Microbiology of ventilator-associated pneumonia compared with that of hospital-acquired pneumonia. Infect Control Hosp Epidemiol. 2007 Jul;28(7):825–831.
Journal cover image

Published In

Infect Control Hosp Epidemiol

DOI

ISSN

0899-823X

Publication Date

July 2007

Volume

28

Issue

7

Start / End Page

825 / 831

Location

United States

Related Subject Headings

  • Ventilators, Mechanical
  • Prospective Studies
  • Pneumonia, Ventilator-Associated
  • Pneumonia, Bacterial
  • Infection Control
  • Humans
  • Gram-Positive Bacteria
  • Gram-Negative Bacteria
  • Equipment Contamination
  • Epidemiology