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Ventilator-associated Pneumonia caused by commensal oropharyngeal Flora; [corrected] a retrospective Analysis of a prospectively collected Database
- Source :
- BMC Pulmonary Medicine, BMC Pulmonary Medicine, 15:86. BioMed Central Ltd
- Publication Year :
- 2015
-
Abstract
- BACKGROUND: The significance of commensal oropharyngeal flora (COF) as a potential cause of ventilator-associated pneumonia (VAP) is scarcely investigated and consequently unknown. Therefore, the aim of this study was to explore whether COF may cause VAP. METHODS: Retrospective clinical, microbiological and radiographic analysis of all prospectively collected suspected VAP cases in which bronchoalveolar lavage fluid exclusively yielded >/= 10(4) cfu/ml COF during a 9.5-year period. Characteristics of 899 recent intensive care unit (ICU) admissions were used as a reference population. RESULTS: Out of the prospectively collected database containing 159 VAP cases, 23 patients were included. In these patients, VAP developed after a median of 8 days of mechanical ventilation. The patients faced a prolonged total ICU length of stay (35 days [P < .001]), hospital length of stay (45 days [P = .001]), and a trend to higher mortality (39 % vs. 26 %, [P = .158]; standardized mortality ratio 1.26 vs. 0.77, [P = .137]) compared to the reference population. After clinical, microbiological and radiographic analysis, COF was the most likely cause of respiratory deterioration in 15 patients (9.4 % of all VAP cases) and a possible cause in 2 patients. CONCLUSION: Commensal oropharyngeal flora appears to be a potential cause of VAP in limited numbers of ICU patients as is probably associated with an increased length of stay in both ICU and hospital. As COF-VAP develops late in the course of ICU admission, it is possibly associated with the immunocompromised status of ICU patients.
- Subjects :
- Male
medicine.medical_treatment
Oropharynx
SOFA SCORE
law.invention
law
Risk Factors
Hospital Mortality
Netherlands
Incidence (epidemiology)
Incidence
Ventilator-associated pneumonia
Pneumonia, Ventilator-Associated
Middle Aged
Commensal oropharyngeal flora
INTENSIVE-CARE UNITS
Intensive care unit
PULMONARY INFECTIONS
Intensive Care Units
SOFA score
Female
Erratum
CRITICALLY-ILL PATIENTS
Bronchoalveolar Lavage Fluid
Research Article
Bronchoalveolar lavage
Pulmonary and Respiratory Medicine
medicine.medical_specialty
ANTIBIOTIC-THERAPY
DIAGNOSIS
Internal medicine
NEUTROPENIC PATIENTS
medicine
Humans
Intensive care medicine
METAANALYSIS
Retrospective Studies
Mechanical ventilation
CYSTIC-FIBROSIS
Bacteria
business.industry
Retrospective cohort study
medicine.disease
MALDI-TOF-MS
Respiration, Artificial
respiratory tract diseases
Pneumonia
Standardized mortality ratio
business
Subjects
Details
- ISSN :
- 14712466
- Volume :
- 15
- Database :
- OpenAIRE
- Journal :
- BMC pulmonary medicine
- Accession number :
- edsair.doi.dedup.....fae2799858d5e40726b769df24f2fd51