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Community-acquired bacteria frequently detected by means of quantitative polymerase chain reaction in nosocomial early-onset ventilator-associated pneumonia

Apfalter, Petra ; Stoiser, Brigitte ; Barousch, Wolfgang ; Nehr, Marion ; Kramer, Ludwig ; Burgmann, Heinz

Critical care medicine, 2005-07, Vol.33 (7), p.1492-1498 [Periódico revisado por pares]

Hagerstown, MD: by the Society of Critical Care Medicine and Lippincott Williams & Wilkins

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Community-acquired bacteria frequently detected by means of quantitative polymerase chain reaction in nosocomial early-onset ventilator-associated pneumonia
Autor: Apfalter, Petra ; Stoiser, Brigitte ; Barousch, Wolfgang ; Nehr, Marion ; Kramer, Ludwig ; Burgmann, Heinz
Assuntos: Adult ; Aged ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Biological and medical sciences ; Blood. Blood and plasma substitutes. Blood products. Blood cells. Blood typing. Plasmapheresis. Apheresis ; Bronchoalveolar Lavage Fluid - microbiology ; Cross Infection - diagnosis ; Cross Infection - etiology ; Cross Infection - microbiology ; Emergency and intensive respiratory care ; Female ; Hospital Bed Capacity, 500 and over ; Hospitals, Teaching ; Humans ; Intensive care medicine ; Intensive Care Units ; Male ; Medical sciences ; Middle Aged ; Pneumonia, Bacterial - diagnosis ; Pneumonia, Bacterial - etiology ; Pneumonia, Bacterial - microbiology ; Polymerase Chain Reaction - methods ; Prospective Studies ; Respiration, Artificial - adverse effects ; Transfusions. Complications. Transfusion reactions. Cell and gene therapy
É parte de: Critical care medicine, 2005-07, Vol.33 (7), p.1492-1498
Notas: ObjectType-Article-1
SourceType-Scholarly Journals-1
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Descrição: OBJECTIVE:To test whether real-time polymerase chain reaction allows for rapid quantitative detection of Streptococcus pneumoniae, Chlamydia pneumoniae, Mycoplasma pneumoniae, and Legionella pneumophila in bronchoalveolar lavage fluids and to determine the prevalence of these pathogens in nosocomial ventilator-associated pneumonia. DESIGN:Prospective epidemiologic study applying a new molecular biology-based diagnostic tool during a 27-month period. SETTING:Three medical intensive care units of a tertiary care university hospital. PATIENTS:One hundred patients suffering from nosocomial ventilator-associated pneumonia, hospitalized for ≥14 days, intubated for reasons other than pneumonia, and mechanically ventilated for >48 hrs. INTERVENTIONS:None. MEASUREMENTS AND MAIN RESULTS:S. pneumoniae, M. pneumoniae, and C. pneumoniae were detected in bronchoalveolar lavage fluids of 100 patients in 20 (20%), three (3%), and two (2%) cases, respectively. There of 17 (71%) revealed no growth or no significant growth by conventional culture. In one patient, S. pneumoniae and M. pneumoniae were detected simultaneously. Corresponding colony-forming units/mL were partly up to 10 CFU/mL with Gram stainings showing signs of acute inflammation in 80%. A significant temporary correlation between the number of days on ventilator, development of nosocomial pneumonia, and the frequency of detection of these pathogens was found for day 4. CONCLUSIONS:S. pneumoniae, M. pneumoniae, and C. pneumoniae should be considered as causative agents in critically ill patients who develop early-onset nosocomial ventilator-associated pneumonia. Thus, empirical antimicrobial regimens should cover S. pneumoniae, Chlamydia, and Mycoplasma alike. Quantitative polymerase chain reaction is a fast diagnostic tool allowing for detection of these bacteria within 3 hrs in pretreated patients.
Editor: Hagerstown, MD: by the Society of Critical Care Medicine and Lippincott Williams & Wilkins
Idioma: Inglês

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Community-acquired bacteria frequently detected by means of quantitative polymerase chain reaction in nosocomial early-onset ventilator-associated pneumonia

Apfalter, Petra ; Stoiser, Brigitte ; Barousch, Wolfgang ; Nehr, Marion ; Kramer, Ludwig ; Burgmann, Heinz

Hagerstown, MD: by the Society of Critical Care Medicine and Lippincott Williams & Wilkins

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