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.

scholarly journals Incidence and Outcome of Ventilator Associated Pneumonia in ICU of a Tertiary Care Hospital in Nepal

2017 ◽  
Vol 56 (207) ◽  
pp. 304-308 ◽  
Author(s):  
Deebya Raj Mishra ◽  
Niharika Shah ◽  
Dibya Singh Shah
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pulmonary Infection ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Clinical Pulmonary Infection Score ◽  
P Value ◽  
Ventilator Associated Pneumonia ◽  
Care Hospital ◽  
Ventilated Patients

Introduction: Ventilator associated pneumonia is an important intensive care unit acquired infection in mechanically ventilated patients. Early and correct diagnosis of Ventilator associated pneumonia is difficult but is an urgent challenge for an optimal antibiotic treatment. Methods: A prospective observational study was conducted in Intensive Care Unit of a tertiary care hospital in Nepal. Consecutive patients were considered during the study period, who met the criteria were included for the study. Clinical Pulmonary Infection Score was used to diagnose Ventilator associated pneumonia. Results: Among 60 patients ventilated for more than 48 hours, 25 (41.6%) developed ventilator associated pneumonia. The incidence was 25 VAPs per 100 ventilated patients or 26 VAPs per 1000 ventilator days during the period of study. Days on ventilator and duration in ICU were higher in the VAP group. There was a trend towards increasing mortality in the VAP group (P value=0.06). Conclusions: There exists a high rate of VAP in our Intensive Care Unit. Targeted strategies aimed at reducing Ventilator associated pneumonia should be implemented to improve patient outcome and reduce length of Intensive Care Unit stay and costs. Keywords: clinical pulmonary infection score; incidence; ventilator associated pneumonia.

Effect of Backrest Elevation on the Development of Ventilator-Associated Pneumonia

2005 ◽  
Vol 14 (4) ◽  
pp. 325-332 ◽  
Author(s):  
Mary Jo Grap ◽  
Cindy L. Munro ◽  
Russell S. Hummel ◽  
R.K. Elswick ◽  
Jessica L. McKinney ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Medical Records ◽  
Pulmonary Infection ◽  
Severity Of Illness ◽  
Clinical Pulmonary Infection Score ◽  
Ventilator Associated Pneumonia ◽  
Entire Study ◽  
System Data ◽  
The Mean ◽  
The Relationship

• Background Ventilator-associated pneumonia is a common complication of mechanical ventilation. Backrest position and time spent supine are critical risk factors for aspiration, increasing the risk for pneumonia. Empirical evidence of the effect of backrest positions on the incidence of ventilator-associated pneumonia, especially during mechanical ventilation over time, is limited. • Objective To describe the relationship between backrest elevation and development of ventilator-associated pneumonia. • Methods A nonexperimental, longitudinal, descriptive design was used. The Clinical Pulmonary Infection Score was used to determine ventilator-associated pneumonia. Backrest elevation was measured continuously with a transducer system. Data were obtained from laboratory results and medical records from the start of mechanical ventilation up to 7 days. • Results Sixty-six subjects were monitored (276 patient days). Mean backrest elevation for the entire study period was 21.7°. Backrest elevations were less than 30° 72% of the time and less than 10° 39% of the time. The mean Clinical Pulmonary Infection Score increased but not significantly, and backrest elevation had no direct effect on mean scores. A model for predicting the Clinical Pulmonary Infection Score at day 4 included baseline score, percentage of time spent at less than 30° on study day 1, and score on the Acute Physiology and Chronic Health Evaluation II, explaining 81% of the variability (F=7.31, P=.003). • Conclusions Subjects spent the majority of the time at backrest elevations less than 30°. Only the combination of early, low backrest elevation and severity of illness affected the incidence of ventilator-associated pneumonia.

The value of pretest probability and modified clinical pulmonary infection score to diagnose ventilator-associated pneumonia

2008 ◽  
Vol 23 (1) ◽  
pp. 50-57 ◽  
Author(s):  
François Lauzier ◽  
Annie Ruest ◽  
Deborah Cook ◽  
Peter Dodek ◽  
Martin Albert ◽  
...  
Keyword(s):  
Pulmonary Infection ◽  
Pretest Probability ◽  
Clinical Pulmonary Infection Score ◽  
Ventilator Associated Pneumonia

Use of the clinical pulmonary infection score to guide therapy for ventilator-associated pneumonia risks antibiotic overexposure in patients with trauma

2012 ◽  
Vol 73 (1) ◽  
pp. 52-59 ◽  
Author(s):  
Nancy A. Parks ◽  
Louis J. Magnotti ◽  
Jordan A. Weinberg ◽  
Ben L. Zarzaur ◽  
Thomas J. Schroeppel ◽  
...  
Keyword(s):  
Pulmonary Infection ◽  
Clinical Pulmonary Infection Score ◽  
Ventilator Associated Pneumonia

Clinical pulmonary infection score to diagnose ventilator-associated pneumonia in children

2011 ◽  
Vol 48 (12) ◽  
pp. 949-954 ◽  
Author(s):  
Anil Sachdev ◽  
K. Chugh ◽  
M. Sethi ◽  
D. Gupta ◽  
C. Wattal ◽  
...  
Keyword(s):  
Pulmonary Infection ◽  
Clinical Pulmonary Infection Score ◽  
Ventilator Associated Pneumonia

One-Week versus 2-Day Ventilator Circuit Change in Neonates with Prolonged Ventilation: Cost-Effectiveness and Impact on Ventilator-Associated Pneumonia

2014 ◽  
Vol 36 (3) ◽  
pp. 287-293 ◽  
Author(s):  
Shih-Ming Chu ◽  
Mei-Chin Yang ◽  
Hsiu-Feng Hsiao ◽  
Jen-Fu Hsu ◽  
Reyin Lien ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Cost Effectiveness ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Ventilator Associated Pneumonia ◽  
Ventilator Circuit ◽  
Mechanical Ventilators ◽  
Prolonged Intubation ◽  
The Impact

ObjectiveTo investigate the impact of 1-week ventilator circuit change on ventilator-associated pneumonia and its cost-effectiveness compared with a 2-day change.DesignAn observational cohort study.SettingA tertiary level neonatal intensive care unit in a university-affiliated teaching hospital in Taiwan.PatientsAll neonates in the neonatal intensive care unit receiving invasive intubation for more than 1 week from July 1, 2011, through December 31, 2013.InterventionWe investigated the impact of 2 ventilator circuit change regimens, either every 2 days or 7 days, on ventilator-associated pneumonia of our cohort.Measurements and Main ResultsA total of 361 patients were maintained on mechanical ventilators for 13,981 days. The 2 groups did not differ significantly in any demographic characteristics. The rate of ventilator-associated pneumonia was comparable between the 2-day group and the 7-day group (8.2 vs 9.5 per 1,000 ventilator-days, P=.439). The durations of mechanical ventilation and hospital stay, and rates of bloodstream infection and mortality, were also comparable between the 2 groups. Switching from a 2-day to a 7-day change policy would save our neonatal intensive care unit a yearly sum of US $29,350 and 525 working hours.ConclusionDecreasing the frequency of ventilator circuit changes from every 2 days to once per week is safe and cost-effective in neonates requiring prolonged intubation for more than 1 week.Infect Control Hosp Epidemiol 2014;00(0): 1–7

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