Antibiotic pre-administration increases risk of nosocomial pneumonia and fatal outcome
Abstract
The objective of this investigation was to analyse previous antibiotic treatment before nosocomial pneumonia onset and the etiology of nosocomial pneumonias in 70 adult patients admitted to the Novosibirsk Regional Hospital between January 1993 and June 1997.
The results showed that previous antibiotic administration took place in 87.1% of cases and was more frequent (p<0.05) in patients with fatal outcome. Gram-negative pathogènes, especially Pseudomonas aeruginosa and Klebsiella pneumoniae, were the prevalent etiological agents. Gram-negative microorganisms (firstly Pseudomonas aeruginosa) and polymicrobial etiology of nosocomial pneumonias were revealed in the majority of patients received antibiotics before nosocomial pneumonia onset. Stathylococcus aureus as the etiological agent of nosocomial pneumonia was registered more frequently in patients with fatal outcome.
About the Authors
N. P. Domnikova
Новосибирский медицинский институт
Russian Federation
Russian Federation
L. D. Sidorova
Новосибирский медицинский институт
Russian Federation
Russian Federation
V. N. IIjina
Новосибирский медицинский институт
Russian Federation
Russian Federation
References
1. American Thoracic Society: Campbell G.D., Niederman M.S., Broughton W.A. et al. Hospital-acquired pneumonia in adults: diagnosis, assessment of soverity, initial antimicrobial therapy, and preventative strategies. A consunsus statement / / Am. J. Respir. Crit. Care Med.— 1995.— Vol.153.— P.1711 — 1725.
2. Chow J.W., Fine M.J., Shlaes D.M. et al. Enterobacter bacteremia: clinical features and emergence of antibiotic resistance during therapy / / Ann. Intern. Med.— 1991.— Vol.115, № 8.— P.585—590.
3. Craven D.T., Steger K.A., Barber T.W. Preventing nosocomial pneumonia: state of the art and perspectives for the 1990s / / Am. J. Med.— 1991.— Vol.91, № 3.— PtB.— P.44S—53S.
4. Croce M.A., Fabian T.C., Stewart R.M., Pritchard F.E., Minard G., Trent hem L., Kudsk K.A. Empiric monotherapy versus combination therapy of nosocomial pneumonia in trauma patients / / J. Trauma.- 1993.- Vol.35, № 2 . - P.303—311.
5. Fagon J.Y., Chastre J., Hance A.J., Novara A., Gibert C. Nosocomial pneumonia in ventilated patients: a cohort study evaluating attributable mortality and hospital stay / / Am. J. Med.— 1993.— Vol.94, № 3.— P.281—288.
6. Fagon J.Y., Chastre J., Vuagnat A., Trouillet J.L., Novara A., Gibert C. Nosocomial pneumonia and mortality among patients in intensive care units / / J. Am. Med. Assoc.— 1996.— Vol.275, № 11.— P.866—869.
7. Kollef M.H. Ventilator-associated pneumonia: a multivariate analysis / / Ibid.— 1993.— Vol.270, № 16.— P.1965—1970.
8. Kollef M.H., Wragge T., Pasque C. Determinants of multiorgan disfunction in cardiac surgery patients requiring prolonged mechanical ventilation / / Chest.— 1995.— Vol.107, № 5.— P.1395—1401.
9. Lipchik R.J., Kuzo R.S. Nosocomial pneumonia / / Radiol. Clin. North Am.— 1996.— Vol.34, № 1.— P.47—58.
10. Mandell L.A., Marrie T.J., Niederman M.S. and the Canadian Hospital Acquired Pneumonia Consensus Conference Group. Initial antimicrobial treatment of hospital acquiered pneumonia in adults: a conference report / / Can. J. Infect. Dis.— 1993.— Vol.4.— P.317—321.
11. Meyer K.S., Urban C., Eagan J.A., Berger B.J., Rahal J.J. Nosocomial outbreak of Klebsiella infection resistant to late-generation cephalosporins / / Ann. Intern. Med.— 1993.— Vol.l 19, № 5.— P.353—358.
12. Rello J., Ausina V., Ricart М., Castella J., Prats G. Impact of previous antimicrobial therapy on the tiology and outcome of ventilator-associated pneumonia / / Chest.— 1993.— Vol.104, № 16.— P.1230—1235.
13. Rello J., Ausina V., Ricart М., Puzo C., Quintana E., Net A., Prats G. Risk factors for infection by Pseudomonas aeruginosa in patients with ventilator-associated pneumonia / / Intensive Care Med.— 1994.— Vol.20, № 3.— P.193—198.
14. Rello J., Torres A., Ricart М., Valles J., Gonzales J., Artigas A., Rodrigues-Roisin R. Ventilator associated pneumonia by Staphylococcus aureus. Comparision of meticillin-resistant and meticillinsensitive episodes / / Am. J. Respir. Crit. Care Med.— 1994.— Vol. 150.— P. 1545—1549.
15. Weinstin R.A. Epidemiology and control of nosocomial infections in adult intensive care units / / Am. J. Med.— 1991.— Pt 3, Suppl. B.— P.179S—184S.
Review
For citations:
Domnikova N.P., Sidorova L.D., IIjina V.N. Antibiotic pre-administration increases risk of nosocomial pneumonia and fatal outcome. PULMONOLOGIYA. 1998;(4):23-27. (In Russ.)
Views:
5565
Email this article 