Characteristic | Patient | |||||||
---|---|---|---|---|---|---|---|---|
 | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 |
Medical history | Fatty liver, arterial hypertension | Smoking, arterial hypertension, pulmonary oedema, heart attack, mild chronic renal failure | Liver hamartoma, chronic obstructive pulmonary disease, urinary incontinence, hypothyroidism, Sjögren's syndrome, excised left frontal lobe meningioma | Catarract, cholosteatoma, arterial hypertension, urinary tract infection 3 weeks before admission | Wolff–Parkinson–White syndrome, chronic renal failure (polycystic kidney disease), ankylosing spondylitis | Smoking, obesity, chronic obstructive pulmonary disease | Arterial hypertension, chronic renal dysfunction (creatinine clearance 75–80 ml/min), adenoma of hypophysis, epileptic seizures, cerebral haemorrhage | Arterial hypertension, cerebral arteriovenous malformation |
Reason for admission | Stomach lymphoma | Acute myocardial infarction | Epileptic seizures | Fever, headache | Multitrauma patient, C4–C5 fractures due to car accident, functional dissection of spinal cord, haemothorax | Oesophageal perforation | Adenoma of hypophysis, cerebral haemorrhage | Pneumonia, sleep apnoea syndrome, cerebral haemorrhage |
Discharge diagnosis | Stomach lymphoma, nosocomial pneumonia | Acute myocardial infarction, nosocomial pneumonia | Postsurgical intracranial haematoma, pulmonary embolism, inferior vena cava filter placement | Pneumococcal meningitis, hydrocephalus, pulmonary embolism, pneumonia, urinary tract infection | Septic shock, multiple organ failure | Mediastinitis | Pneumonia | Pneumonia, sleep apnoea syndrome, cerebral haemorrhage |
APACHE II score on ICU admission | 14 | 17 | 17 | 9 | 12 | 17 | 19 | 12 |
APACHE II score on first day of colistin treatment | 10 | 29 | 19 | 8 | 19 | 20 | 18 | 14 |
Surgery during hospitalization | Liver biopsy, partial gastrectomy | Coronary artery bypass surgery | Drainage of postsurgical haematoma of left frontal lobe, inferior vena cava filter placement | Endoscopic ethmoidectomy, surgical drainage of the frontal and maxillary sinuses | Spinal arthrodesis surgery (C5–T1) | Surgical repair of oesophageal perforation | Excision of pituitary adenoma | Embolization of arteriovenous malformation |
Duration of mechanical ventilation (days) | 10 | 16 | 5 | 18 | 65 | 25 | 8 | 8 |
Time from ICU admission to develop the infection for which aerosolized colistin was given (days) | 8 | 1 | 7 | 22 | 24 | 1 | 7 | 5 |
Site of infection | Pneumonia (VAP) | Pneumonia, urinary tract infection | Bacteraemia, pneumonia (VAP) | Pneumonia (VAP) | Pneumonia (VAP) | Pneumonia | Pneumonia (VAP) | Pneumonia (VAP) |
Isolated micro-organism (source) | Acinetobacter baumannii (BAL) | A baumannii (bronchial secretions) | A baumannii (blood), A baumannii (bronchial secretions) | Pseudomonas aeruginosa (bronchial secretions) | A baumannii (bronchial secretions) | A baumannii (BAL) | A baumannii (bronchial secretions) | A baumannii (bronchial secretions) |
Susceptibility of the isolated pathogen | MDR (sensitive to colistin and gentamycin) | COS | COS | COS | MDR (sensitive to colistin and gentamycin) | COS | MDR (sensitive to colistin and gentamycin) | MDR (sensitive to colistin and gentamycin) |
Duration/dosage of nebulized colistin | 6 days/1 million IU q8 h | 13 days/1 million IU q8 h | 10 days/0.5 million IU q8 h | 5 days/1.5 million IU q8 h | 7 days/2 million IU q8 h | 3 days/1 million IU q8 h | 8 days/0.5 million IU q6 h | 19 days/1 million IU q8 h |
Duration/dosage of concomitant intravenous antibiotic treatment | Colistin: 2 days/3 million IU q8 h, 6 days/2 million IU q8 h Levofloxacin: 3 days/500 mg q24 h Co-trimoxazole: 4 days/3 ampules q8 h Ciprofloxacin 4 days/400 mg q12 h | Colistin: 14 days/1 million IU q8 h Meropenem: 12 days/1 g q12 h | Colistin: 26 days/3 million IU q8 h Meropenem: 26 days/2 g q8 h | She received intravenous colistin before nebulized treatment (7 days/1 million IU q8 h) and after the end of nebulized treatment (32 days/1 million IU q8 h) | Tobramycin: 7 days/80 mg q24 h Aztreonam: 3 days/1 g q8 h | Colistin: 14 days/2 million IU q8 h Meropenem: 15 days/2 g q8 h Gentamicin: 8 days/80 mg q8 h | Colistin: 8 days/2 million IU q8 h Meropenem: 4 days/2 g q8 h | Meropenem: 27 days/2 g q8 h Gentamicin: 27 days/80 mg q8 h |
Duration of hospitalization (days) | 17 | 16 | 41 | 234 | 94 | 25 | 36 | 40 |
Duration of ICU stay (days) | 11 | 16 | 21 | 62 | 95 | 25 | 13 | 20 |
Outcome of infection | Cure | Improvement | Cure | Improvement | Deterioration | Improvement | Cure | Cure |
Outcome of patient | Discharge | Discharge | Discharge | Discharge | Death | Discharge | Discharge | Discharge |
Serum creatinine value (mg/dl) on the first day of aerosolized colistin administration | 1.1 | 5.2 | 1 | 0.4 | 2.4 | 0.6 | 0.8 | 0.8 |
Serum creatinine value (mg/dl) at the end of aerosolized colistin administration | 0.8 | 4.5 | 0.9 | 0.5 | 3.8 | 0.5 | 0.7 | 0,6 |