OBJECTIVE: To investigate if tracheal colonisation within 24 h of intubation is a risk factor for developing early-onset ventilator-associated pneumonia (EP) in patients with head trauma. DESIGN: A prospective study in an intensive care unit of a university hospital. POPULATION: One hundred intubated patients were included with head trauma and Glasgow coma score at admission < or =12. METHODS: We took tracheal aspirate samples within 24 h of intubation and performed a protected bronchoalveolar mini-lavage when clinical diagnosis of pneumonia was made. MEASUREMENTS AND RESULTS: On admission time 68 patients (68%) were colonised in trachea, 22 patients were colonised by Staphylococcus aureus, 20 by Haemophilus influenzae, six by Streptococcus pneumoniae and 20 by gram-negative bacilli. The incidence of EP was 26%, and the microorganisms involved were Staph. aureus (44%), H. influenzae (31%), Strep. pneumoniae (12%), and gram-negative bacilli (13%). A multivariate logistic regression analysis showed that the tracheal colonization by Staph. aureus, H. influenzae or Strep. pneumoniae within 24 h of intubation was an independent risk factor for developing EP (odds ratio: 28.9; 95% confidence interval: 1.59-52.5). CONCLUSION: Colonisation of the trachea within 24 h of intubation by Staphylococcus aureus, Haemophilus influenzae or Streptococcus pneumoniae is a risk factor for developing EP in patients with head trauma.
OBJECTIVE: To investigate if tracheal colonisation within 24 h of intubation is a risk factor for developing early-onset ventilator-associated pneumonia (EP) in patients with head trauma. DESIGN: A prospective study in an intensive care unit of a university hospital. POPULATION: One hundred intubated patients were included with head trauma and Glasgow coma score at admission < or =12. METHODS: We took tracheal aspirate samples within 24 h of intubation and performed a protected bronchoalveolar mini-lavage when clinical diagnosis of pneumonia was made. MEASUREMENTS AND RESULTS: On admission time 68 patients (68%) were colonised in trachea, 22 patients were colonised by Staphylococcus aureus, 20 by Haemophilus influenzae, six by Streptococcus pneumoniae and 20 by gram-negative bacilli. The incidence of EP was 26%, and the microorganisms involved were Staph. aureus (44%), H. influenzae (31%), Strep. pneumoniae (12%), and gram-negative bacilli (13%). A multivariate logistic regression analysis showed that the tracheal colonization by Staph. aureus, H. influenzae or Strep. pneumoniae within 24 h of intubation was an independent risk factor for developing EP (odds ratio: 28.9; 95% confidence interval: 1.59-52.5). CONCLUSION: Colonisation of the trachea within 24 h of intubation by Staphylococcus aureus, Haemophilus influenzae or Streptococcus pneumoniae is a risk factor for developing EP in patients with head trauma.
Authors: Marc Leone; Stéphane Delliaux; Aurélie Bourgoin; Jacques Albanèse; Franck Garnier; Ioana Boyadjiev; Francois Antonini; Claude Martin Journal: Intensive Care Med Date: 2004-12-02 Impact factor: 17.440
Authors: Lakshmi Durairaj; Zeinab Mohamad; Janice L Launspach; Alix Ashare; James Y Choi; Srinivasan Rajagopal; Gary V Doern; Joseph Zabner Journal: J Crit Care Date: 2009-03 Impact factor: 3.425
Authors: Jose L Pascual; Nicholas W Blank; Daniel N Holena; Matthew P Robertson; Mouhamed Diop; Steve R Allen; Niels D Martin; Benjamin A Kohl; Carrie A Sims; C William Schwab; Patrick M Reilly Journal: J Trauma Acute Care Surg Date: 2014-04 Impact factor: 3.313