Ventilator-Associated Pneumonia Caused by Pseudomonas aeruginosa in Intensive Care Unit: Epidemiology and Risk Factors
- *Corresponding Author:
- Enrico Raineri
Service of Intensive Care
Intensive Care and Neuroanaesthesia Institutes Hospital of Cremona
vialeConcordia 1, 26100 Cremona, Italy
E-mail: [email protected]
Received Date: February 06, 2014; Accepted Date: July 22, 2014; Published Date: July 24, 2014
Citation: Raineri E, Porcella L, Acquarolo A, Crema L, Albertario F, et al. (2014) Ventilator-Associated Pneumonia Caused by Pseudomonasaeruginosa in Intensive Care Unit: Epidemiology and Risk Factors. J Med Microb Diagn 3:149. doi: 10.4172/2161-0703.1000149
Copyright: © 2014 Raineri E, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Purpose: We studied the risk factors for the acquisition of Ventilator-associated Pneumonia (VAP) caused by Pseudomonas aeruginosa in two Intensive Care Units (ICU).
Methods: We carried out a case-control study, from January 1, 2006 through June 30, 2008. We defined as CASES patients with Pseudomonas aeruginosa VAP and CONTROLS patients with VAP caused by other Gramnegative bacteria.
Results: The study of risk factors for the development of VAP by Pseudomonas aeruginosa showed that three of them are referred to the pre-ICU admission history of the patient: hospitalization during previous 6 months, admission from other wards/hospitals instead of domicile provenance (p<0.01) and duration of pre-ICU hospitalisation (p<0.01, at multivariate analysis: OR 2.09 IC95% 1.18-3.72). Analysis of antibiotic prescription before the development of VAP showed as independent risk factor the number of different antibiotic classes prescribed to patients or rather the complexity of antibiotic exposure (OR 2.3 IC95% 1.14-4.67). Analysis of mortality revealed a non-significant difference between VAP caused by Pseudomonas or other Gram-negative bacteria, although our data suggest an association between MDR Pseudomonas infection and higher mortality (p=0.03).
Conclusion: Our study offers points that can contribute to improve the empiric antibiotic prescription in ICU. In presence of in-hospital patients presenting with a previous history of antibiotic prescription, with a complex clinical condition preceding ICU admission or with a prolonged ventilatory assistance, presenting with signs or symptoms of infection, should be advisable to prescribe a therapy with a specific activity against Pseudomonas aeruginosa.