title: Ventilator-associated pneumonia patients who do not reduce bacteria from the lungs have a worse prognosis.
abstract: The authors determined the significance of serial semi-quantitative bronchoalveolar lavage (BAL) culture results in patients undergoing therapy for ventilator-associated pneumonia. A total of 32 patients underwent at least 2 nonbronchoscopic BAL studies. Fourteen patients had methicillin-resistant Staphylococcus aureus (MRSA). Of these, 11 had more than 100 colony-forming units (cfu) of MRSA/mL of BAL from the follow-up BAL. Eighteen patients had an organism other than MRSA, and 7 of these patients had > 100 cfu of bacteria/mL of BAL from the follow-up BAL. Of the 18 patients with > 100 cfu of bacteria/mL of BAL at follow-up, 14 (79%) died, whereas only 5 of 14 (36%) patients who cleared their bacteria at follow-up died within 28 days. The inability to reduce the bacterial burden from the lower respiratory tract within the first few days of therapy for ventilator-associated pneumonia was associated with increased mortality.
authors.affiliation: University of Cincinnati Medical Center, Cincinnati, OH 45267-0565, USA. bob.baughman@uc.edu
authors.forename: Robert P
authors.initials: RP
authors.lastname: Baughman
authors.forename: Marie A
authors.initials: MA
authors.lastname: Kerr
mesh_terms: D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000627:therapeutic use; D001992:Bronchoalveolar Lavage Fluid / Q000382:microbiology*; D015169:Colony Count, Microbial; D003428:Cross Infection / Q000209:etiology / Q000401:mortality / Q000628:therapy; D017052:Hospital Mortality; D006801:Humans; D016013:Likelihood Functions; D016106:Methicillin Resistance; D008991:Monitoring, Physiologic / Q000379:methods / Q000592:standards; D009079:Mucociliary Clearance; D018410:Pneumonia, Bacterial / Q000209:etiology / Q000401:mortality / Q000628:therapy; D011018:Pneumonia, Pneumococcal / Q000209:etiology / Q000401:mortality / Q000628:therapy; D011023:Pneumonia, Staphylococcal / Q000209:etiology / Q000401:mortality / Q000628:therapy; D011379:Prognosis; D012121:Respiration, Artificial / Q000009:adverse effects*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D016868:Serratia Infections / Q000209:etiology / Q000401:mortality / Q000628:therapy; D013183:Sputum / Q000382:microbiology; D013211:Staphylococcus aureus; D016019:Survival Analysis; D013997:Time Factors; D014640:Vancomycin / Q000009:adverse effects / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D014640:Vancomycin