The effect of prior antimicrobial therapy for community acquired infections on the aetiology of early and late onset ventilator-associated pneumonia in a level I trauma intensive care unit

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Background: Ventilator-associated pneumonia (VAP) is the most common hospital acquired infection in patients who require mechanical ventilation. Early VAP is associated with community acquired pathogens whereas late VAP involves hospital flora. Based on this premise, a protocol may be formulated for microbiological surveillance and antimicrobial stewardship within a specific intensive care unit (ICU) to ensure appropriate empiric antimicrobial choice. The bacterial flora in VAP may be affected, however, by antimicrobials prescribed during the ICU stay.Aim: The aim of this study was to determine the effect of prior antimicrobial therapy for community acquired infections on aetiology and the susceptibility of bacterial isolates from the first episode of early or late VAP in a trauma intensive care unit.Methods: Endotracheal aspirates (ETAs) were obtained from patients with suspected early and late VAP. All ETAs were processed and interpreted as per the Clinical and Laboratory Standards Institute (CLSI). Pat...