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Ventilator-Associated Pneumonia in a Multi-Hospital System Differences in Microbiology by Location

Published online by Cambridge University Press:  02 January 2015

Hilary M. Babcock ,
Jeanne E. Zack ,
Teresa Garrison ,
Ellen Trovillion ,
Marin H. Kollef  and
Victoria J. Fraser
Hilary M. Babcock*
Affiliation:
Division of Infectious Diseases, Washington University School of Medicine, St. Louis, Missouri
Jeanne E. Zack
Affiliation:
Departments of Hospital Epidemiology and Infection Control, Barnes-Jewish Hospital, St. Louis, Missouri
Teresa Garrison
Affiliation:
Departments of Hospital Epidemiology and Infection Control, Barnes-Jewish Hospital, St. Louis, Missouri
Ellen Trovillion
Affiliation:
Departments of Hospital Epidemiology and Infection Control, Barnes-Jewish Hospital, St. Louis, Missouri
Marin H. Kollef
Affiliation:
Pulmonary and Critical Care Division, Washington University School of Medicine, St. Louis, Missouri
Victoria J. Fraser
Affiliation:
Division of Infectious Diseases, Washington University School of Medicine, St. Louis, Missouri
*
Campus Box 8051, 660 South Euclid Avenue, St. Louis, MO 63110
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Abstract

Objective:

To determine whether there were differences in the microbiologic etiologies of ventilator-associated pneumonia in different clinical settings.

Design:

Observational retrospective cohort study of microbiologic etiologies of ventilator-associated pneumonia from 1998 to 2001 in a multi-hospital system. Microbiologic results were compared between hospitals and between different intensive care units (ICUs) within hospitals.

Setting:

Three hospitals—one pediatric teaching hospital, one adult teaching hospital, and one community hospital— in one healthcare system in the midwestern United States.

Patients:

Patients at the target hospitals who developed ventilator-associated pneumonia and for whom microbiologic data were available.

Results:

Seven hundred fifty-three episodes of ventilator-associated pneumonia had culture data available for review. The most common organisms at all hospitals were Staphylococcus aureus (28.4%) and Pseudomonas aeruginosa (25.2%). The pediatric hospital had higher proportions of Escherichia coli (9.5% vs 2.3%; P < .001) and Klebsiella pneumoniae (13% vs 3.1%; P < .001) than did the adult hospitals. In the pediatric hospital, the pediatric ICU had higher P. aeruginosa rates than did the neonatal ICU (33.3% vs 17%; P = .01). In the adult hospitals, the surgical ICU had higher Acinetobacter baumannii rates (10.2% vs. 1.7%; P < .001) than did the other ICUs.

Conclusions:

Microbiologic etiologies of ventilator-associated pneumonia vary between and within hospitals. Knowledge of these differences can improve selection of initial antimicrobial regimens, which may decrease mortality.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 24 , Issue 11 , November 2003 , pp. 853 - 858
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2003

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