Mortality due to ventilator-associated pneumonia or colonization with Pseudomonas or Acinetobacter species: Assessment by quantitative culture of samples obtained by a protected specimen brush
Mortality due to ventilator-associated pneumonia or colonization with Pseudomonas or Acinetobacter species: Assessment by quantitative culture of samples obtained by a protected specimen brush
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DOI：
10.1093/clinids/23.3.538
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发表时间：
1996-09-01
影响因子：
11.8
通讯作者：
Gibert, C
中科院分区：
文献类型：
--
作者：
Fagon, JY;Chastre, J;Gibert, C
由多重耐药病原体引起的呼吸机相关性肺炎（VAP）与高死亡率相关。我们通过比较细菌计数< 10（3）cfu/mL的假单胞菌或不动杆菌引起的VAP患者与细菌计数大于或等于10（3）cfu/mL的肺炎患者的结局，分析了假单胞菌或不动杆菌引起的VAP与死亡之间的关系。当怀疑肺炎时，用受保护的标本刷系统地采集样本。在入住我们的重症监护室时的临床特征和怀疑VAP时的临床特征在定植患者和VAP患者之间没有显著差异。定植患者的死亡率为29%，VAP患者的死亡率为73%（P <0.001）。这些结果表明，高死亡率与接受呼吸支持患者下呼吸道中多重耐药、非发酵、革兰氏阴性杆菌（大于或等于10（3）cfu/mL）引起的肺炎发生之间存在相关性。
Ventilator-associated pneumonia (VAP) due to multiresistant pathogens is associated with a high death rate. We analyzed the relationship between VAP due to Pseudomonas or Acinetobacter species and death by comparing the outcomes for patients colonized with these pathogens (bacterial counts of < 10(3) cfu/mL) with those for patients with pneumonia due to these pathogens (bacterial counts of greater than or equal to 10(3) cfu/mL). Samples were obtained systematically with a protected specimen brush when pneumonia was suspected. Clinical characteristics at admission to our intensive care unit and clinical features at the time of suspicion of VAP were not significantly different between colonized patients and those with VAP. Mortality rates were 29% among colonized patients and 73% among patients with VAP (P < .001). These results demonstrate a relationship between a high mortality rate and the development of pneumonia due to multiresistant, nonfermenting, gram-negative bacilli (greater than or equal to 10(3) cfu/mL) in the lower airways of patients receiving ventilatory support.