Nosocomial pneumonia mortality according to antibiotic sensibility of the microorganism responsible

Objective

To analyze the mortality of ventilator-asociated pneumonia (VAP) produced for a potential multiresistant microorganism (PMRM) according to antibiotic sensibility of the microorganisms responsible.

Methods

It is a prospective study of patients admitted in the ICU from 1 May 2000 until 31 August 2002 and who developed VAP produced for a PMRM (Staphylococcus aureus, Pseudomonas aeruginosa, Stenotrophomona maltofilia, Acinetobacter). The statistical analysis was realized by chi-square test and Student t test, and we took values P < 0.05 to consider a significant difference.

Results

In the study period, 1389 patients were admitted. We documented 66 VAP for a PMRM. VAP mortality for MSSA versus MRSA was 27.77% (5/18) and 14.28% (2/14) (P = 0.35). VAP mortality for a Gram-negative bacilli PMRP was analyzed according to the sensitivity to four antibiotics (piperacillin–tazobactam, ceftazidime, imipenem and ciprofloxacin). VAP mortality for P. aeruginosa with 0–1 antibiotic resistances versus 2–4 antibiotic resistances was 2/22 (9.09%) and 2/4 (50%) (P = 0.03). VAP mortality for S. maltofilia with 0–2 antibiotic resistances versus 3–4 antibiotic resistances was 0/2 (0%) and 2/2 (100%) (P = 0.04). VAP mortality for Acinetobacter with 0 antibiotic resistances versus 1–4 antibiotic resistances was 0/2 (0%) and 1/2 (50%) (P = 0.24).

Conclusions

In our series, the VAP mortality for P. aeruginosa and S. maltofilia was different according to antibiotic sensibility, but not when it was due to S. aureus and Acinetobacter.