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Ventilator-Associated Pneumonia and Surgical Patients

David A. Spain, MD
Author and Funding Information

Affiliations: Stanford, CA
 ,  Dr. Spain is Chief of Trauma/Surgical Clinical Care, Department of Surgery.

Correspondence to: David A. Spain, MD, Chief of Trauma/Surgical Clinical Care, Department of Surgery, Stanford University, 300 Pasteur Dr H3680, Stanford, CA 94303-5655; e-mail: dspain@stanford.edu



Chest. 2002;121(5):1390-1391. doi:10.1378/chest.121.5.1390
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I suspect that many intensivists caring for patients with ventilator-associated pneumonia (VAP) would assume that patients with polymicrobial infections had worse outcomes, had a greater chance for inadequate empiric coverage, were more likely to have resistant organisms, etc. However, in the study by Combes et al (see page 1618), although almost half of their patients had polymicrobial VAP, no difference in outcomes was observed. The authors correctly point out that this may be due to the manner in which these patients arrived to them (ie, most were receiving mechanical ventilation at hospital admission, had significant underlying disease, and, most importantly, many were receiving antibiotic therapy at the time of diagnosis). Thus, the similar outcomes for patients with monomicrobial and polymicrobial pneumonia are not so surprisingly.

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