Abstract
Mortality rate of nosocomial pneumonia in ventilated ICU patients (pts) is about 20-25%. Despite advances in critical care, standard criteria for pneumonia are still inaccurate. Antibiotherapy is often started on a 'best guess' basis to anticipate frequently negative bacteriological results (Ba-cul). Main etiological pathogens are staphylococci, streptococci, pseudomonads and enterobacteriaceae. A multigenotypic and sequential molecular identification (Mol-id) was applied on bronchoalveolar lavages (BAL) from 12 pts with clinical-radiological evidence of infection with (n = 9)/without (n = 3) positive Ba-cul. DNA extraction and duplicate specific amplification of 16S rDNA from BAL was first used to identify signals corresponding to the presence of Gram + (G+), Gram - (G-), or mixed G+/G-. Any G+ signal was followed by femA and mecA multiplex (mpx)-PCR for species-specific identification of staphylococci and methicillin resistance, and by mpx-PCR for S. pneumoniae. Any G- signal was followed by mpx-PCR for species-specific identification of Pseudomonads (aeruginosa, cepacia, maltophilia) vs other G- for which the 16S rDNA amplicon was sequenced. Mol-id identified mixed G+/G- in 2/3 negative Ba-cul. Ba-cul gave G+ or G- only in 3 and 4/12 pts, respectively. Among these, Mol-id confirmed either G+ (2/3) or G- (2/4), and found a mixed signal in 3/7 pts. Mixed G+/G- was found by Ba-cul and Mol-id in 2/12 BAL, but in one case, S. epidermidis was found by Mol-id and enterococci by Ba-cul. Staphylococci (MRSA, other) and Ps. aeruginosa were found by Ba-cul and Mol-id in 2 and 3 pts, respectively. Current results suggest that Mol-id is a useful adjunct bringing more insight to standard criteria of nosocomial pneumoniae in ICU and can be a timely relevant guide for antibiotherapy.
Highlights
In our experience, very often, even with a nonrebreathing mask (NRM), high oxygen delivery to patient with the existent materials is insufficient
TMSORG for R, C, N and Re were significantly associated with HM
P109 How we reduce allogenic blood transfusions in the patients undergoing surgery of ascending aorta D Radojevic, Z Jankovic, B Calija, M Jovic, B Djukanovic
Summary
Very often, even with a nonrebreathing mask (NRM), high oxygen delivery to patient with the existent materials is insufficient. There is evidence that increasing the dose of continuous renal replacement therapy (CRRT) is associated with improved survival in critically ill patients with acute renal failure (ARF) [1]. The aim of this study is to investigate if there is any difference in patients’ characteristics in ICU between COPD and nonCOPD diseases caused chronic respiratory failure and require mechanical ventilation during acute exacerbations. Noninvasive positive pressure ventilation (NPPV) has been reported to be beneficial in the treatment of acute exacerbation of chronic obstructive pulmonary disease (COPD), and to facilitate weaning In this trial we assessed the possible benefit of early NPPV in patients with blunt chest trauma and acute respiratory failure. The aim of this study was to compare the pharmacokinetic and pharmacodynamic parameters and the clinical efficacy of a continuous infusion of cefepime versus an intermittent regimen in critically ill adults patients with gram negative bacilli infection. The purpose of the study is to identify the factors associated with DNR status in our institution
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
