0
Clinical Investigations in Critical Care |

Incidence and Outcome of Polymicrobial Ventilator-Associated Pneumonia*

Alain Combes, MD; Corinne Figliolini, MD; Jean-Louis Trouillet, MD; Najibi Kassis, MD; Michel Wolff, MD; Claude Gibert, MD; Jean Chastre, MD
Author and Funding Information

*From Service de Réanimation Médicale (Drs. Combes, Trouillet, Gibert, and Chastre), Service de Réanimation Infectieuse (Drs. Figliolini and Wolff), and Service de Microbiologie (Dr. Kassis), Hôpital Bichat, AP-HP, Paris, France.

Correspondence to: Alain Combes, MD, Service de Réanimation Médicale, Institute de Cardìologie, Hopital Pitié-Salpêtrière, 47 Boulevard de l’Hôpital, 75651 Paris Cedex 13, France; e-mail: alain.combes@psl.ap-hop-paris.fr



Chest. 2002;121(5):1618-1623. doi:10.1378/chest.121.5.1618
Text Size: A A A
Published online

Study objective: To determine the epidemiology and outcome of polymicrobial ventilator-associated pneumonia (VAP).

Setting: Two ICUs (18 and 17 beds) in a university hospital.

Design and patients: We undertook a 16-month study of 124 patients in whom a first episode of VAP had been diagnosed. Patients in whom there was a suspicion of clinical or radiologic VAP underwent bronchoscopy, and VAP was confirmed by the presence of at least two of the following criteria: ≥ 2% of cells with intracellular bacteria found on direct examination of BAL fluid (BALF); protected-specimen brush sample culture with ≥ 103 cfu/mL; or BALF culture with ≥ 104 cfu/mL.

Results: Monomicrobial infections were diagnosed in 65 patients (52%), and polymicrobial infections were diagnosed in 59 patients (48%). Two different bacteria were isolated in 42 patients (34%), three different bacteria were isolated in 10 patients (8%), and four different bacteria were isolated in 7 patients (6%). Patients’ clinical characteristics at ICU admission and on the day of bronchoscopy were similar, particularly the prior duration of mechanical ventilation (MV), the type of ICU admission, disease severity scores, and antibiotic therapy received before VAP was diagnosed. The percentages of nonfermenting, Gram-negative bacilli and methicillin-resistant staphylococci involved in monomicrobial and polymicrobial episodes were similar. Furthermore, no significant difference was detected in outcome parameters, specifically in the mortality rate at 30 days, the ICU mortality rate, the duration of MV, and the rate of infection relapse.

Conclusion: In our study population, the epidemiology and outcomes of patients with monomicrobial and polymicrobial VAP did not differ significantly.

Figures in this Article

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
PubMed Articles
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543