Five-year trends for ventilator-associated pneumonia: Correlation between microbiological findings and antimicrobial drug consumption.

The epidemiology of multidrug-resistant bacteria (MDRB) has changed significantly in European healthcare settings, with a decrease in frequency of meticillin-resistant Staphylococcus aureus and an increase in extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae. Little is known about the effects of these changes on ventilator-associated pneumonia (VAP). A retrospective 5-year trend analysis of ICU antibiotic consumption and resistance in bacteria causing VAP was undertaken. Poisson regression analysis between complete microbiological data and antibiotic consumption was performed. In total, 252 episodes of VAP in 184 patients were identified between 2007 and 2011, from which 364 causal bacteria were isolated. Enterobacteriaceae isolation rates increased significantly over this period [from 6.64 to 10.52 isolates/1000 patient-days; P=0.006], mostly due to an increase in AmpC-producing Enterobacteriaceae (APE) (2.85-4.51 isolates/1000 patient-days; P=0.013), whereas the number of episodes due to S. aureus and Pseudomonas aeruginosa remained stable. A positive association was found between the increase in APE infections and an increase in past-year antibiotic consumption: amoxicillin/clavulanic acid (P=0.003), ceftazidime and cefepime (P=0.007), carbapenems (P=0.002), fluoroquinolones (P=0.012), macrolides (P=0.002) and imidazoles (P=0.004). No such association was found for the emergence of resistance in P. aeruginosa. These results indicate a change in the epidemiology of VAP, with Enterobacteriaceae exceeding P. aeruginosa and S. aureus. Moreover, a positive correlation was observed between antibiotic consumption and the incidence of potentially MDRB such as APE. No such correlation was found for ESBL-producing Escherichia coli and antibiotic-resistant P. aeruginosa.

Fihman V ，Messika J ，Hajage D ，Tournier V ，Gaudry S ，Magdoud F ，Barnaud G ，Billard-Pomares T ，Branger C ，Dreyfuss D ，Ricard JD ... -  《-》

Bacteriological profile of ventilator-associated pneumonia in a tertiary care hospital.

Patro S ，Sarangi G ，Das P ，Mahapatra A ，Mohapatra D ，Paty BP ，Chayani N ... -  《-》

Device-associated nosocomial infection rates in intensive care units of seven Indian cities. Findings of the International Nosocomial Infection Control Consortium (INICC).

Mehta A ，Rosenthal VD ，Mehta Y ，Chakravarthy M ，Todi SK ，Sen N ，Sahu S ，Gopinath R ，Rodrigues C ，Kapoor P ，Jawali V ，Chakraborty P ，Raj JP ，Bindhani D ，Ravindra N ，Hegde A ，Pawar M ，Venkatachalam N ，Chatterjee S ，Trehan N ，Singhal T ，Damani N ... -  《JOURNAL OF HOSPITAL INFECTION》

Resistance Rates of Intra-Abdominal Isolates from Intensive Care Units and Non-Intensive Care Units in the United States: The Study for Monitoring Antimicrobial Resistance Trends 2010-2012.

Hackel MA ，Badal RE ，Bouchillon SK ，Biedenbach DJ ，Hoban DJ ... -  《-》

Diagnosing ventilator-associated pneumonia in pediatric intensive care.

The Centers for Disease Control and Prevention's criteria were applied by independent investigators for ventilator-associated pneumonia (VAP) diagnosis in critically ill children and compared with tracheal aspirate cultures (TACs). In addition, correlation between antibiotic use, VAP incidence, and epidemiology of TACs was investigated. A modest agreement (κ = 0.41) was found on radiologic findings between 2 investigators. VAP incidence was 7.7 episodes per 1,000 ventilator days, but positive TACs were the most significant factor for driving high antimicrobial usage in the pediatric intensive care unit.

Iosifidis E ，Stabouli S ，Tsolaki A ，Sigounas V ，Panagiotidou EB ，Sdougka M ，Roilides E ... -  《-》