TY - JOUR
T1 - High level cephalosporin-resistant Enterobacteriaceae ventilator-associated pneumonia: Prognostic factors based on a cohort study
AU - Aubron, Cecile
AU - Chaari, A
AU - Bronchard, R
AU - Armand-Lefevre, L
AU - Montravers, Philippe
AU - Regnier, B
AU - Wolff, M
AU - Lucet, J-C
PY - 2011
Y1 - 2011
N2 - The impact of high level cephalosporin resistance due to Enterobacteriaceae harbouring a type I-inducible chromosomal b-lactamase on the outcome of ventilator-associated pneumonia
(VAP) remains unknown. A retrospective cohort study was conducted in two intensive care units (ICUs) over a four-year period to identify factors prognostic of VAP caused by high level AmpC (HL-AmpC)-producing Enterobacteriaceae. The study included 75 patients, who developed
VAP due to Enterobacteriaceae harbouring a type I-inducible chromosomal b-lactamase. One-third of these VAP episodes were due to HL-AmpC-producing Enterobacteriaceae. Demographic and clinical characteristics at ICU admission were similar for patients, regardless
of Enterobacteriaceae susceptibility, but those who developed VAP due to HL-AmpC-producing Enterobacteriaceae received antibiotics more frequently before its onset and had higher disease severity and organ dysfunction scores. Enterobacter spp. were the major HL-AmpCproducing
micro-organisms responsible for VAP. VAP due to HL-AmpC-producing Enterobacteriaceae is rare. High level cephalosporin resistance was not associated with higher day 28 mortality, despite its association with more severe disease at VAP onset.
AB - The impact of high level cephalosporin resistance due to Enterobacteriaceae harbouring a type I-inducible chromosomal b-lactamase on the outcome of ventilator-associated pneumonia
(VAP) remains unknown. A retrospective cohort study was conducted in two intensive care units (ICUs) over a four-year period to identify factors prognostic of VAP caused by high level AmpC (HL-AmpC)-producing Enterobacteriaceae. The study included 75 patients, who developed
VAP due to Enterobacteriaceae harbouring a type I-inducible chromosomal b-lactamase. One-third of these VAP episodes were due to HL-AmpC-producing Enterobacteriaceae. Demographic and clinical characteristics at ICU admission were similar for patients, regardless
of Enterobacteriaceae susceptibility, but those who developed VAP due to HL-AmpC-producing Enterobacteriaceae received antibiotics more frequently before its onset and had higher disease severity and organ dysfunction scores. Enterobacter spp. were the major HL-AmpCproducing
micro-organisms responsible for VAP. VAP due to HL-AmpC-producing Enterobacteriaceae is rare. High level cephalosporin resistance was not associated with higher day 28 mortality, despite its association with more severe disease at VAP onset.
UR - http://www.ncbi.nlm.nih.gov/pubmed/21129817
U2 - 10.1016/j.jhin.2010.09.010
DO - 10.1016/j.jhin.2010.09.010
M3 - Article
SN - 0195-6701
VL - 77
SP - 64
EP - 69
JO - Journal of Hospital Infection
JF - Journal of Hospital Infection
IS - 1
ER -