title: Hospital-acquired pneumonia in ICU patients.
abstract: BACKGROUND
  This prospective study aimed at assessing the effect of initial antibiotic therapy on the mortality of patients with hospital-acquired pneumonia (HAP) by analyzing bacterial pathogens and their resistance to antimicrobial agents.
  
  
  METHODS
  Included were patients hospitalized in the Department of Anesthesiology and Intensive Care Medicine, Faculty of Medicine and Dentistry, Palacký University Olomouc and University Hospital Olomouc in 2009 who developed HAP. Bacterial pathogens and their resistance to antibiotics were identified using standard microbiological methods. The patient's mortality with respect to their initial antibiotic therapy was statistically analyzed.
  
  
  RESULTS
  The group comprised 51 patients with HAP. Early-onset HAP was identified in 7 (14%) patients and late-onset HAP in 44 (86%) patients. The most frequent bacterial pathogens were strains of Klebsiella pneumoniae, Pseudomonas aeruginosa, Burkholderia cepacia complex and Escherichia coli, together accounting for 72%. Eighteen patients died directly due to HAP, an overall mortality rate of 35%. If initial therapy effective against the bacterial pathogen was selected, 21 patients survived and 9 died. If the bacterial pathogens were resistant to the selected initial antibiotic therapy, 9 patients died and 12 survived.
  
  
  CONCLUSIONS
  The mortality rates were 30% and 43% for adequate and inadequate antibiotic therapy, respectively. Given the small group of patients, the difference has low statistical significance. However, it does document the clinical impact of bacterial resistance on the survival or death of patients with HAP.
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, University Hospital Olomouc, Palacky University Olomouc, Czech Republic. radovan.uvizl@seznam.cz
authors.forename: Radovan
authors.initials: R
authors.lastname: Uvizl
authors.forename: Vojtěch
authors.initials: V
authors.lastname: Hanulik
authors.forename: Vendula
authors.initials: V
authors.lastname: Husickova
authors.forename: Miroslava Htoutou
authors.initials: MH
authors.lastname: Sedlakova
authors.forename: Milan
authors.initials: M
authors.lastname: Adamus
authors.forename: Milan
authors.initials: M
authors.lastname: Kolar
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D003428:Cross Infection / Q000188:drug therapy* / Q000382:microbiology / Q000401:mortality; D024881:Drug Resistance, Bacterial; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D018410:Pneumonia, Bacterial / Q000188:drug therapy* / Q000382:microbiology / Q000401:mortality; D015996:Survival Rate; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents