Clinical spectrum of ventilator-associated pneumonia caused by methicillin-sensitiveStaphylococcus aureus

  • D. Bergmans
  • M. Bonten
  • C. Gaillard
  • P. de Leeuw
  • F. van Tiel
  • E. Stobberingh
  • S. van der Geest
Articles

DOI: 10.1007/BF01691309

Cite this article as:
Bergmans, D., Bonten, M., Gaillard, C. et al. Eur. J. Clin. Microbiol. Infect. Dis. (1996) 15: 437. doi:10.1007/BF01691309

Abstract

The incidence of tracheal colonization and its association with ventilator-associated pneumonia caused by methicillin-sensitiveStaphylococcus aureus (MSSA) was studied prospectively in 530 consecutively admitted mechanically ventilated patients in a general intensive care unit. Furthermore, the clinical spectrum, outcome, and microbiological results of 27 cases of staphylococcal ventilator-associated pneumonia (SVAP) were examined. Ventilator-associated pneumonia was diagnosed by protected specimen brush and/or bronchoalveolar lavage. On admission, 7% of the patients were colonized with MSSA in the trachea. Acquired tracheal colonization was demonstrated in 10% of the patients and occurred less frequently in patients with a hospital stay of > 48 h before ICU admission compared to patients admitted directly to the ICU (6% vs. 15%, p<0.001). Moreover, colonization was acquired more frequently among trauma and neurological/neurosurgical patients (22%) as compared to surgical and medical patients (7%) (p<0.0001). Twenty-one patients (4%) developed SVAP, the incidence being higher in patients colonized in the trachea with MSSA than in those not colonized (21 % vs. 1 %, p<0.00001). Staphylococcal ventilator-associated pneumonia developed more often in trauma and neurological/neurosurgical patients as compared to surgical and medical patients (8% vs. 3%, p<0.05). Moreover, patients with a hospital stay of < 48 h before admission to the ICU had a higher incidence of SVAP as compared to those with a longer hospital stay before ICU admission (7% vs. 2%, p<0.01). Crude infection-related mortality was 26%. Preceding colonization with MSSA in the trachea appears to be an important risk factor for the development of SVAP, and patients with a short duration of hospitalization before intensive care unit admission have the highest incidence of ventilator-associated pneumonia caused by MSSA.

Copyright information

© MMV Medizin Verlag GmbH 1996

Authors and Affiliations

  • D. Bergmans
    • 1
  • M. Bonten
    • 1
  • C. Gaillard
    • 3
  • P. de Leeuw
    • 1
  • F. van Tiel
    • 2
  • E. Stobberingh
    • 2
  • S. van der Geest
    • 1
  1. 1.Department of Internal MedicineUniversity Hospital MaastrichtAZ MaastrichtThe Netherlands
  2. 2.Department of Medical MicrobiologyUniversity Hospital MaastrichtAZ MaastrichtThe Netherlands
  3. 3.Department of Internal MedicineEemland HospitalED AmersfoortThe Netherlands

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