Risk factors for infection by Pseudomonas aeruginosa in patients with ventilator-associated pneumonia.
OBJECTIVE
to investigate the epidemiology of infection by Pseudomonas aeruginosa in patients with ventilator-associated pneumonia (VAP).


METHODS
prospective clinical study.


METHODS
a medical-surgical ICU in a university hospital.


METHODS
we followed-up 568 mechanically ventilated patients and 83 episodes of VAP with etiologic diagnosis in 72 patients were retained for analysis.


RESULTS
Ps. aeruginosa was isolated in 22 (26.5%) episodes in 18 patients. Of these episodes 7 were directly responsible for death. Using logistic regression analysis, the risk of VAP due to Ps. aeruginosa was increased in patients with chronic obstructive pulmonary disease (relative risk (RR) = 29.9, 95% confidence interval (CI) = 4.86-184.53), a mechanical ventilation period longer than 8 days (RR = 8.1, 95% CI = 1.01-65.40) and prior use of antibiotics (RR = 5.5, 95% CI = 0.88-35.01).


CONCLUSIONS
patients with VAP and these factors have a greater risk of infection by Ps. aeruginosa and empirical therapy for these episodes should include anti-pseudomonal activity until etiologic diagnosis is established.
Intensive Care Department, Hospital de Sabadell, Barcelona, Spain.
J
J
Rello
V
V
Ausina
M
M
Ricart
C
C
Puzo
E
E
Quintana
A
A
Net
G
G
Prats
D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002423:Cause of Death; D016001:Confidence Intervals; D003428:Cross Infection / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D017053:Infection Control; D007362:Intensive Care Units; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011014:Pneumonia / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy; D011446:Prospective Studies; D011552:Pseudomonas Infections / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy; D011550:Pseudomonas aeruginosa; D012121:Respiration, Artificial / Q000009:adverse effects*; D012307:Risk Factors; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents