CASETTA A, BRIVET F, BOUTROS N, NUNES H, TROCHE G, CASANOVA F, LEBRUN L; Interscience Conference on Antimicrobial Agents and Chemotherapy.
Abstr Intersci Conf Antimicrob Agents Chemother Intersci Conf Antimicrob Agents Chemother. 2000 Sep 17-20; 40: 410.
Lab. of Bacteriology, Antoine Beclere Hosp., Clamart, France
BACKGROUND: Pseudomonas aeruginosa is a frequent cause of late-onset ventilator associated pneumonia (VAP) in intensive care units (ICU). Multiresistant strains, frequently detected in ICU patients, complicate the choice of initial therapy in treating late-onset VAP. Recently the gastrointestinal tract is considered the most important endogenous source of P. aeruginosa.METHODS: To determine if antibiotic susceptibility of P. aeruginosa strains isolated from surveillance rectal swabs may serve to select initial therapy in late-onset VAP, we have compared resistance pattern (RP) and genotype by PFGE of P. aeruginosa strains isolated from surveillance rectal swabs and from quantitative cultures of bronchoscopic samples. Influence of current antibiotic treatment (CAT) was analyzed.RESULTS: Thirty-six patients were included and 44 cases were analyzed. In untreated patients (31 cases), 80% of strains isolated from the two sites from each patients had the same RP, 84% of those were genotypically undistinguishable and 16% were unrelated. Among untreated patients, the 20% remaining cases had different RP, 66% of those were genotypically related and 34% were unrelated. In all of these 20% remaining cases, the pulmonary strains were more susceptible than rectal strains. In patients with CAT (13 cases), 23% of strains from each patient had the same RP and were genotypically undistinguishable. In the 77% remaining cases, the strains had different RP and were genotypically undistinguishable. In all of these 77% cases the pulmonary strains were more resistant than rectal strains suggested selection of resistant mutants from rectal strains. In conclusion, these results help to find a more rational basis of selecting therapy for patients suspected of having late-onset VAP.KEYWORDS: Antibiotic therapy; Pseudomonas aeruginosa; Ventilator-associated pneumonia
Publication Types:
Keywords:
- Animals
- Anti-Bacterial Agents
- Bacteria
- Cats
- Electrophoresis, Gel, Pulsed-Field
- Humans
- Intensive Care
- Intensive Care Units
- Pneumonia
- Pseudomonas aeruginosa
- Respiration, Artificial
- Risk Management
- Ventilators, Mechanical
- analysis
- economics
- epidemiology
- instrumentation
- organization & administration
- surgery
- therapy
Other ID:
UI: 102247710
From Meeting Abstracts