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Infect Control Hosp Epidemiol. 2003 Nov;24(11):853-8.

Ventilator-associated pneumonia in a multi-hospital system: differences in microbiology by location.

Author information

1
Division of Infectious Diseases, Washington University School of Medicine, USA.

Abstract

OBJECTIVE:

To determine whether there were differences in the microbiologic etiologies of ventilator-associated pneumonia in different clinical settings.

DESIGN:

Observational retrospective cohort study of microbiologic etiologies of ventilator-associated pneumonia from 1998 to 2001 in a multi-hospital system. Microbiologic results were compared between hospitals and between different intensive care units (ICUs) within hospitals.

SETTING:

Three hospitals--one pediatric teaching hospital, one adult teaching hospital, and one community hospital--in one healthcare system in the midwestern United States.

PATIENTS:

Patients at the target hospitals who developed ventilator-associated pneumonia and for whom microbiologic data were available.

RESULTS:

Seven hundred fifty-three episodes of ventilator-associated pneumonia had culture data available for review. The most common organisms at all hospitals were Staphylococcus aureus (28.4%) and Pseudomonas aeruginosa (25.2%). The pediatric hospital had higher proportions of Escherichia coli (9.5% vs 2.3%; P < .001) and Klebsiella pneumoniae (13% vs 3.1%; P < .001) than did the adult hospitals. In the pediatric hospital, the pediatric ICU had higher P aeruginosa rates than did the neonatal ICU (33.3% vs 17%; P = .01). In the adult hospitals, the surgical ICU had higher Acinetobacter baumannii rates (10.2% vs. 1.7%; P < .001) than did the other ICUs.

CONCLUSIONS:

Microbiologic etiologies of ventilator-associated pneumonia vary between and within hospitals. Knowledge of these differences can improve selection of initial antimicrobial regimens, which may decrease mortality.

PMID:
14649775
DOI:
10.1086/502149
[Indexed for MEDLINE]

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