scholarly journals QI: Modified Clinical Pulmonary Infection Score as a Surrogate Tool to Guide Antibiotic De-Escalation in Patients With Hospital-Acquired, Healthcare-Associated and Ventilator-Associated Pneumonia in Intensive Care Units

2015 ◽  
Vol 2 (suppl_1) ◽  
Author(s):  
Nino Balanchivadze ◽  
Rajany Dy ◽  
John Boyce
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Pulmonary Infection ◽  
Clinical Pulmonary Infection Score ◽  
Ventilator Associated Pneumonia ◽  
Healthcare Associated ◽  
Hospital Acquired

Predictive Values of Quantitative VS Qualitative Culture of Broncholaveolar Lavage in Diagnosis of Ventilator Associated Pneumonia in Patients on Mechanical Ventilation

2019 ◽  
Vol 4 (05) ◽  
Author(s):  
Maja Travar ◽  
Pedja Kovacevic ◽  
Darko Golic
Keyword(s):  
Mechanical Ventilation ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Pulmonary Infection ◽  
Clinical Pulmonary Infection Score ◽  
Ventilator Associated Pneumonia ◽  
Quantitative Culture ◽  
Predictive Values ◽  
Hospital Acquired

Purpose: Ventilator associated pneumonia (VAP) is one of the most common hospital-acquired infection in patients hospitalized in intensive care unit (ICU). Aim of this study was to evaluate predictive values of quantitative and qualitative culture of broncholaveolar lavage (BAL) in the diagnosis of VAP comparing with clinical pulmonary infection score (CPIS), and to determine positive and negative predictive values of the tests in patients on mechanical ventilation. Methodology: 209 samples were prospectively taken from the patients hospitalized in ICU on mechanical ventilation; along with the clinical pulmonary infection score (CPIS). After sampling, quantitative and qualitative culture of BAL was done. As the cut off value of quantitative culture 104 CFU/mL was taken, according CDC recommendations. Results: In our study, sensitivity of the quantitative culture of BAL was 91%, specificity 70%, positive predictive value 80% and negative predictive value was 85%. Sensitivity of the qualitative culture of BAL was 93%, specificity 36%, positive predictive value 70,2% and negative predictive value was 76%. Conclusion: Quantitative culture of BAL has better predictive values in VAP diagnosis in patients on mechanical ventilation, helping in the discrimination between colonization and the infection. Qualitative culture of BAL has higher sensitivity, but lower specificity than quantitative culture.

scholarly journals Etiology, incidence and mortality in patients with ventilator-associated pneumonia in adult general surgery and cardiac surgery intensive care units in University Hospital Dubrava

2020 ◽  
Vol 39 (4) ◽  
pp. 124-128
Author(s):  
Andrea Karin ◽  
Andrej Šribar ◽  
Marko Pražetina ◽  
Katerina Bakran ◽  
Jasminka Peršec
Keyword(s):  
Cardiac Surgery ◽  
Intensive Care ◽  
Intensive Care Units ◽  
General Surgery ◽  
University Hospital ◽  
Ventilator Associated Pneumonia ◽  
Timely Initiation ◽  
Incidence And Mortality ◽  
Hospital Acquired Pneumonia ◽  
Hospital Acquired

Ventilator-associated pneumonia (VAP) and hospital acquired pneumonia (HAP) strongly contribute to morbidity and mortality in intensive care units. Hospital acquired pneumonia (HAP) is pneumonia occurring 48 hours upon admission and appears not to be incubating at the time of admission. Ventilator-associated pneumonia (VAP) is a type of HAP developing in intubated patients after more than 48 hours upon mechanical ventilation. HAP and VAP are common and serious complications present in hospitalized patients. Since the diagnosis of VAP and HAP are rarely documented, we wanted to assess the incidence of VAP in General Surgery and Cardiac Surgery Intensive Care Units in 2018 and analyse the patients and procedures related factors. Patients intubated and ventilated more than 96 hours during 2018 were included. Our findings have shown that incidence of VAP in two analysed ICUs in UH Dubrava is in line with VAP incidence found in literature due to successful preventive strategies and timely initiation of antimicrobial therapy and other adjunctive procedures.

scholarly journals Quantitative biofilm for bacterial pathogens of ventilator-associated pneumonia

2021 ◽  
Vol 25 (2) ◽  
Author(s):  
Fitri Hapsari Dewi ◽  
Suradi . ◽  
Bambang Purwanto ◽  
Brian Wasita
Keyword(s):  
Intensive Care ◽  
Endotracheal Tube ◽  
Diagnostic Tool ◽  
Pulmonary Infection ◽  
Bacterial Pathogens ◽  
Clinical Care ◽  
Clinical Pulmonary Infection Score ◽  
Teaching Hospitals ◽  
Ventilator Associated Pneumonia ◽  
Mechanical Ventilators

Background & Objective: Ventilator–associated pneumonia (VAP) is one of the most common nosocomial infections in clinical care settings. Several bacteria with biofilm–producing ability offer serious challenge in their eradication. Prompt and accurate diagnosis is needed to provide the best care for the patients. This study aimed to analyze whether biofilm examination using quantitative method can be used as a diagnostic tool for bacterial pathogens associated with VAP. Methodology: This observational analytical study was conducted in Intensive Care Units of three teaching hospitals in Surakarta, Central Java, Indonesia, from November 2019 to April 2020. The subjects were between 19 and 65 y old, with a newly introduced endotracheal tube (ETT) connected to mechanical ventilators, and without pneumonia. Biofilm quantitative measurement used a microtiter plate method from bacterial culture found on ETT at the 48th hour after being mechanically ventilated. The Clinical Pulmonary Infection Score (CPIS) assessment was done at the 48th hour and CPIS of less than 6 was defined as VAP. The analysis used Spearman’s rank and Kendall tau–b correlation. The samples were taken using a consecutive sampling technique.  Results:  A significant correlation between biofilm and VAP was found (ρ = 0.039, p < 0.05). Biofilm was also sufficiently correlated with an increase in CPIS (τb = 0.341, p < 0.05) Conclusions: Quantitative biofilm can be used as a diagnostic tool for establishing the diagnosis of VAP so that appropriate therapy can be administered immediately. Key words: Bacterial pathogen; Biofilm; Ventilator–associated pneumonia Abbreviations: CPIS: Clinical Pulmonary Infection Score; VAP: Ventilator–associated pneumonia; ETT: Endotracheal tube; PCR: Polymerase chain reaction; OD: Optical density Citation: Dewi FH, Suradi, Purwanto B, Wasita B. Quantitative biofilm for bacterial pathogens of ventilator-associated pneumonia. Anaesth. pain intensive care 2021;25(2):132-137. DOI: 10.35975/apic.v25i2.1468 Received: 24 September 2020, Reviewed: 27, 30 October 2020, Accepted: 3 March 2021

scholarly journals Serum and alveolar procalcitonin had a weak diagnostic value for ventilator-associated pneumonia in patients with pulmonary infection score ≥ 6

2018 ◽  
Vol 56 (1) ◽  
pp. 9-14
Author(s):  
Mehran Shokri ◽  
Roya Ghasemian ◽  
Masomeh Bayani ◽  
Parviz Amri Maleh ◽  
Masoumeh Kamrani ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pulmonary Infection ◽  
Inflammatory Marker ◽  
Area Under The Curve ◽  
Clinical Pulmonary Infection Score ◽  
Alveolar Type ◽  
Ventilator Associated Pneumonia ◽  
Cross Sectional ◽  
Procalcitonin Level

Abstract Background. Measuring the serum and alveolar procalcitonin level as inflammatory marker in the diagnosis of ventilator-associated pneumonia (VAP) has been taken into account. In this study, serum and alveolar procalcitonin levels in patients with suspected VAP and patients with confirmed VAP were compared. Methods. This cross-sectional study was conducted using 50 intubated intensive care unit (ICU) patients, connected to ventilator, from October 2014 to April 2015. 50 patients with clinical pulmonary infection score ≥6 were divided into two groups. Patients whose bronchoalveolar lavage (BAL) has shown the growth of more than 104 CFU/mL were included in confirmed VAP group and other patients were included in suspected VAP group. Serum and alveolar procalcitonin levels were measured and compared between both groups. Results. Mean age of patients was 69.10 ± 42.13 with a range of 16-90 years, out of which 23 patients were male (46%) and 27 patients were female (54%). Moreover, patients’ mean clinical pulmonary infection score was reported to be 7.02 ± 1.07. There was a significant relationship between serum and alveolar procalcitonin in suspected patients and patients with an approved form of pneumonia (p = 0.001 and 0.027). Area under the curve for alveolar procalcitonin was 0.683 (sensitivity = 57%; specificity = 80%) and for serum procalcitonin 0.751 (sensitivity = 71%; specificity = 73%) for the diagnosis of VAP. Conclusion. According to the results of the present study, we can diagnose ventilator-associated pneumonia earlier and more accurately by measuring procalcitonin level (particularly alveolar type) in intensive care unit patients.

Hospital-Acquired Pneumonia in the Intensive Care Units of Polish Hospitals

2006 ◽  
Vol 27 (7) ◽  
pp. 784-786
Author(s):  
Jadwiga Wójkowska-Mach ◽  
Małgorzata Bulanda ◽  
Anna Różańska ◽  
Piotr Kochan ◽  
Piotr B. Heczko
Keyword(s):  
Escherichia Coli ◽  
Intensive Care ◽  
Mortality Rate ◽  
Intensive Care Units ◽  
Artificial Ventilation ◽  
Ventilator Associated Pneumonia ◽  
Hospital Acquired Pneumonia ◽  
Hospital Acquired ◽  
Epidemiological Characteristics ◽  
Overall Mortality

We analyzed the epidemiological characteristics of pneumonia in intensive care units of Polish hospitals. Among 11,587 patients, there were 191 cases of hospital-acquired pneumonia (HAP). The incidence of HAP was 5.6%, and that of ventilator-associated pneumonia (VAP) was 17.9%. The overall mortality rate was 12.6%, and the mortality rate for patients who received artificial ventilation was 15.0%. The predominant organisms causing HAP and VAP were Pseudomonas aeruginosa and Escherichia coli, and 21.1% of Staphylococcus aureus isolates were resistant to methicillin.

Hospital-Acquired Pneumonia in the Intensive Care Units of Polish Hospitals

2006 ◽  
Vol 27 (7) ◽  
pp. 784-786 ◽  
Author(s):  
Jadwiga Wójkowska-Mach ◽  
Małgorzata Bulanda ◽  
Anna Różańska ◽  
Piotr Kochan ◽  
Piotr B. Heczko
Keyword(s):  
Escherichia Coli ◽  
Intensive Care ◽  
Mortality Rate ◽  
Intensive Care Units ◽  
Artificial Ventilation ◽  
Ventilator Associated Pneumonia ◽  
Hospital Acquired Pneumonia ◽  
Hospital Acquired ◽  
Epidemiological Characteristics ◽  
Overall Mortality

We analyzed the epidemiological characteristics of pneumonia in intensive care units of Polish hospitals. Among 11,587 patients, there were 191 cases of hospital-acquired pneumonia (HAP). The incidence of HAP was 5.6%, and that of ventilator-associated pneumonia (VAP) was 17.9%. The overall mortality rate was 12.6%, and the mortality rate for patients who received artificial ventilation was 15.0%. The predominant organisms causing HAP and VAP were Pseudomonas aeruginosa and Escherichia coli, and 21.1% of Staphylococcus aureus isolates were resistant to methicillin.

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