کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
3405871 1223487 2016 11 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
The impact of onset time on the isolated pathogens and outcomes in ventilator associated pneumonia
ترجمه فارسی عنوان
تأثیر زمان شروع بر پاتوژن های جدا شده و پیامدهای آن در پنومونی مرتبط با تهویه
کلمات کلیدی
VAP، پنومونی مرتبط با تهویه؛ ICU واحد مراقبت های ویژه؛ MV، تهویه مکانیکی؛ NHSN، شبکه ایمنی ملی بهداشت؛ HAI، عفونت مرتبط با مراقبت های بهداشتی؛ MDRO، ارگانیسم مقاوم در برابر چند دارو؛ EE-VAP، شروع اولیه VAP / اولیه بیمارستان admissi
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی بیماری های عفونی
چکیده انگلیسی

SummarySeveral guidelines base the empirical therapy of ventilator-associated pneumonia (VAP) on the time of onset. However, there is emerging evidence that the isolated microorganisms may be similar regardless of onset time. This study evaluated the characteristics and outcomes of VAP with different onset times. All of the mechanically ventilated patients admitted to the ICU of a 900-bed tertiary-care hospital between 01/08/2003 and 31/12/2010 were prospectively followed for VAP development according to the National Healthcare Safety Network criteria. The patients were categorized into four groups: EO if VAP occurred within 4 days of intubation and hospital admission; LO if VAP occurred after 4 days of admission; EL if VAP occurred within 4 days of intubation, but after the fourth hospitalization day; and LL if VAP occurred after the fourth day of intubation and hospitalization. Out of the 394 VAP episodes, 63 (16%) were EO episodes, 331 (84.0%) were LO episodes, 40 (10.1%) were EL episodes and 291 (73.1%) were LL episodes. The isolated microorganisms were comparable among the four groups, with a similar rate of potentially multidrug resistant organisms in the EO-VAP (31.7%), LO-VAP (40.8%), EL-VAP (37.5%) and LL-VAP (43.3%) samples. The hospital mortality was 24% for EO-VAP cases, 28% for LO-VAP cases, 40% for EL-VAP cases and 49% for LL-VAP cases. However, in the adjusted multivariate analysis, neither LO-VAP, EL-VAP nor LL-VAP was associated with an increased risk of hospital mortality compared with EO-VAP (OR, 0.86 95% CI, 0.34–2.19; 1.22; 95% CI, 0.41–3.68, and 0.95; 95% CI, 0.43–2.10, respectively). In this study, the occurrence of potential multidrug resistant pathogens and the mortality risk were similar regardless of VAP timing from hospital admission and intubation. The bacterial isolates obtained from the VAP cases did not follow an early vs. late-onset pattern, and thus, these terms may not be clinically helpful.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Journal of Infection and Public Health - Volume 9, Issue 2, March–April 2016, Pages 161–171
نویسندگان
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