TY  -  JOUR
AU  -  Raineri, Enrico
AU  -  Porcella, Laura
AU  -  Acquarolo, Annamaria
AU  -  Crema, Luciano
AU  -  Albertario, Fulvio
AU  -  Candiani, Andrea
T1  -  Fattori di rischio per l’acquisizione della Polmonite associata <BR>alla ventilazione meccanica da Pseudomonas aeruginosa<BR>in Terapia Intensiva
PY  -  2015
Y1  -  2015-01-01
DO  -  10.1716/1894.20636
JO  -  GIMPIOS
JA  -  Gimpios
VL  -  5
IS  -  1
SP  -  27
EP  -  33
PB  -  Il Pensiero Scientifico Editore
SN  -  1122-407X
Y2  -  2026/07/18
UR  -  http://dx.doi.org/10.1716/1894.20636
N2  -  Purpose. We studied the risk factors for the acquisition of Ventilator-associated Pneumonia (VAP) caused by Pseudomonas aeruginosa in Intensive Care Unit (ICU). Methods. We carried out a cohort study, from January 1, 2006 through June 30, 2008. We enrolled two cohort of patients: patients with Pseudomonas aeruginosa VAP and patients patients with VAP caused by other Gram-negative bacteria. Results. The study of risk factors for the development of VAP by Pseudomonas aeruginosa showed that three of them are referred to the pre-ICU admission history of the patient: hospitalisation during previous 6 months, admission from other wards/hospitals instead of domicile provenance (p<0.01) and duration of pre-ICU hospitalisation (p<0.01, at multivariate analysis: OR 2.09 IC95% 1.18-3.72). Analysis of antibiotic prescription before the development of VAP, showed as independent risk factor the number of different antibiotic classes prescribed to patients or rather the complexity of antibiotic exposure (OR 2.3 IC95% 1.14-4.67). Analysis of mortality revealed a non significant difference between VAP caused by Pseudomonas or other Gram-negative bacteria, although our data suggest an association between MDR Pseudomonas infection and higher mortality (p=0.03). Conclusion. Our study offers points of reflection that can contribute to improve the empiric antibiotic prescription in ICU. In presence of in-hospital patients presenting with a previous history of antibiotic prescription, with a complex clinical condition preceding ICU admission or with a prolonged ventilatory assistance, presenting with signs or symptoms of infection, should be advisable to prescribe a therapy with a specific activity against Pseudomonas aeruginosa.
ER  -