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.
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.
Authors: Ron Balczon; K Adam Morrow; Chun Zhou; Bradley Edmonds; Mikhail Alexeyev; Jean-Francois Pittet; Brant M Wagener; Stephen A Moser; Silas Leavesley; Xiangming Zha; Dara W Frank; Troy Stevens Journal: FASEB J Date: 2017-03-17 Impact factor: 5.191
Authors: Melissa R Nyendak; David M Lewinsohn; Raj D Shah; Richard G Wunderink; Carl D Koch; Alison Morris; Kolene E McDade; Gaetane C Michaud; Amit K Mahajan; Colleen L Channick; A Christine Argento; Momen M Wahidi; William S Beckett; Gautam George; Carey C Thomson Journal: Ann Am Thorac Soc Date: 2014-09
Authors: Mohammed J Al-Jaghbeer; Julie Ann Justo; William Owens; Joseph Kohn; P Brandon Bookstaver; Jennifer Hucks; Majdi N Al-Hasan Journal: Infection Date: 2018-05-11 Impact factor: 3.553
Authors: Kendra N Iskander; Florin L Craciun; David M Stepien; Elizabeth R Duffy; Jiyoun Kim; Rituparna Moitra; Louis J Vaickus; Marcin F Osuchowski; Daniel G Remick Journal: Crit Care Med Date: 2013-01 Impact factor: 7.598