Ventilator-associated Pneumonia caused by commensal oropharyngeal Flora; [corrected] a retrospective Analysis of a prospectively collected Database
The significance of commensal oropharyngeal flora (COF) as a potential cause of ventilator-associated pneumonia (VAP) is scarcely investigated and consequently unknown. Therefore, the aim of this study was to explore whether COF may cause VAP. Retrospective clinical, microbiological and radiographic...
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| Veröffentlicht in: | BMC pulmonary medicine 2015-08, Vol.15 (1), p.86-86, Article 86 |
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| creator | Scholte, Johannes B J van der Velde, Johan I M Linssen, Catharina F M van Dessel, Helke A Bergmans, Dennis C J J Savelkoul, Paul H M Roekaerts, Paul M H J van Mook, Walther N K A |
| description | The significance of commensal oropharyngeal flora (COF) as a potential cause of ventilator-associated pneumonia (VAP) is scarcely investigated and consequently unknown. Therefore, the aim of this study was to explore whether COF may cause VAP.
Retrospective clinical, microbiological and radiographic analysis of all prospectively collected suspected VAP cases in which bronchoalveolar lavage fluid exclusively yielded ≥ 10(4) cfu/ml COF during a 9.5-year period. Characteristics of 899 recent intensive care unit (ICU) admissions were used as a reference population.
Out of the prospectively collected database containing 159 VAP cases, 23 patients were included. In these patients, VAP developed after a median of 8 days of mechanical ventilation. The patients faced a prolonged total ICU length of stay (35 days [P |
| doi_str_mv | 10.1186/s12890-015-0087-y |
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Retrospective clinical, microbiological and radiographic analysis of all prospectively collected suspected VAP cases in which bronchoalveolar lavage fluid exclusively yielded ≥ 10(4) cfu/ml COF during a 9.5-year period. Characteristics of 899 recent intensive care unit (ICU) admissions were used as a reference population.
Out of the prospectively collected database containing 159 VAP cases, 23 patients were included. In these patients, VAP developed after a median of 8 days of mechanical ventilation. The patients faced a prolonged total ICU length of stay (35 days [P < .001]), hospital length of stay (45 days [P = .001]), and a trend to higher mortality (39 % vs. 26 %, [P = .158]; standardized mortality ratio 1.26 vs. 0.77, [P = .137]) compared to the reference population. After clinical, microbiological and radiographic analysis, COF was the most likely cause of respiratory deterioration in 15 patients (9.4 % of all VAP cases) and a possible cause in 2 patients.
Commensal oropharyngeal flora appears to be a potential cause of VAP in limited numbers of ICU patients as is probably associated with an increased length of stay in both ICU and hospital. As COF-VAP develops late in the course of ICU admission, it is possibly associated with the immunocompromised status of ICU patients.</description><identifier>ISSN: 1471-2466</identifier><identifier>EISSN: 1471-2466</identifier><identifier>DOI: 10.1186/s12890-015-0087-y</identifier><identifier>PMID: 26264828</identifier><language>eng</language><publisher>England: BioMed Central Ltd</publisher><subject>Analysis ; Bacteria - isolation & purification ; Bacterial pneumonia ; Bronchoalveolar Lavage Fluid - microbiology ; Care and treatment ; Development and progression ; Diagnosis ; Female ; Health aspects ; Hospital Mortality - trends ; Hospital patients ; Humans ; Incidence ; Intensive Care Units ; Male ; Middle Aged ; Netherlands - epidemiology ; Oropharynx - microbiology ; Patient outcomes ; Pneumonia ; Pneumonia, Ventilator-Associated - diagnosis ; Pneumonia, Ventilator-Associated - epidemiology ; Pneumonia, Ventilator-Associated - microbiology ; Respiration, Artificial - adverse effects ; Retrospective Studies ; Risk Factors</subject><ispartof>BMC pulmonary medicine, 2015-08, Vol.15 (1), p.86-86, Article 86</ispartof><rights>COPYRIGHT 2015 BioMed Central Ltd.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c256y-5aa1c697f1142cc8495ba0404dd277970bd852ff57d5c67b08e17db3dcbccc183</citedby><cites>FETCH-LOGICAL-c256y-5aa1c697f1142cc8495ba0404dd277970bd852ff57d5c67b08e17db3dcbccc183</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,860,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26264828$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Scholte, Johannes B J</creatorcontrib><creatorcontrib>van der Velde, Johan I M</creatorcontrib><creatorcontrib>Linssen, Catharina F M</creatorcontrib><creatorcontrib>van Dessel, Helke A</creatorcontrib><creatorcontrib>Bergmans, Dennis C J J</creatorcontrib><creatorcontrib>Savelkoul, Paul H M</creatorcontrib><creatorcontrib>Roekaerts, Paul M H J</creatorcontrib><creatorcontrib>van Mook, Walther N K A</creatorcontrib><title>Ventilator-associated Pneumonia caused by commensal oropharyngeal Flora; [corrected] a retrospective Analysis of a prospectively collected Database</title><title>BMC pulmonary medicine</title><addtitle>BMC Pulm Med</addtitle><description>The significance of commensal oropharyngeal flora (COF) as a potential cause of ventilator-associated pneumonia (VAP) is scarcely investigated and consequently unknown. Therefore, the aim of this study was to explore whether COF may cause VAP.
Retrospective clinical, microbiological and radiographic analysis of all prospectively collected suspected VAP cases in which bronchoalveolar lavage fluid exclusively yielded ≥ 10(4) cfu/ml COF during a 9.5-year period. Characteristics of 899 recent intensive care unit (ICU) admissions were used as a reference population.
Out of the prospectively collected database containing 159 VAP cases, 23 patients were included. In these patients, VAP developed after a median of 8 days of mechanical ventilation. The patients faced a prolonged total ICU length of stay (35 days [P < .001]), hospital length of stay (45 days [P = .001]), and a trend to higher mortality (39 % vs. 26 %, [P = .158]; standardized mortality ratio 1.26 vs. 0.77, [P = .137]) compared to the reference population. After clinical, microbiological and radiographic analysis, COF was the most likely cause of respiratory deterioration in 15 patients (9.4 % of all VAP cases) and a possible cause in 2 patients.
Commensal oropharyngeal flora appears to be a potential cause of VAP in limited numbers of ICU patients as is probably associated with an increased length of stay in both ICU and hospital. As COF-VAP develops late in the course of ICU admission, it is possibly associated with the immunocompromised status of ICU patients.</description><subject>Analysis</subject><subject>Bacteria - isolation & purification</subject><subject>Bacterial pneumonia</subject><subject>Bronchoalveolar Lavage Fluid - microbiology</subject><subject>Care and treatment</subject><subject>Development and progression</subject><subject>Diagnosis</subject><subject>Female</subject><subject>Health aspects</subject><subject>Hospital Mortality - trends</subject><subject>Hospital patients</subject><subject>Humans</subject><subject>Incidence</subject><subject>Intensive Care Units</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Netherlands - epidemiology</subject><subject>Oropharynx - microbiology</subject><subject>Patient outcomes</subject><subject>Pneumonia</subject><subject>Pneumonia, Ventilator-Associated - diagnosis</subject><subject>Pneumonia, Ventilator-Associated - epidemiology</subject><subject>Pneumonia, Ventilator-Associated - microbiology</subject><subject>Respiration, Artificial - adverse effects</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><issn>1471-2466</issn><issn>1471-2466</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNptkctu1TAQhiNERUvhAdggS2zYpNhOfDlidVQoIFVqF8AGIWtiT4qRYx_sBCnPwQvjwyk3qfLCnpn_G4_mb5onjJ4xpuWLwrje0JYy0VKqVbvea05Yr1jLeynv__M-bh6W8pVSprToHjTHXHLZa65Pmh8fMc4-wJxyC6Uk62FGR64jLlOKHoiFpdTEsBKbpgljgUBSTrsvkNd4gzW6CCnDS_LJppzRVvozAZJxzqnsauy_I9lGCGvxhaSx1nZ_K2HfNoRfGHkFMwxQ8FFzNEIo-Pj2Pm0-XLx-f_62vbx68-58e9laLuTaCgBm5UaNjPXcWt1vxAC0p71zXKmNooPTgo-jUE5YqQaqkSk3dM4O1lqmu9Pm-aFvHejbgmU2ky8WQ4CIaSmGKdqpulihqvTZQXoDAY2PY5oz2L3cbEVf_--4ZFV1doeqHoeTtyni6Gv-P4AdAFtXUjKOZpf9VDdrGDV7i83BYlMtNnuLzVqZp7dTL8OE7g_x29PuJ7fnpJs</recordid><startdate>20150812</startdate><enddate>20150812</enddate><creator>Scholte, Johannes B J</creator><creator>van der Velde, Johan I M</creator><creator>Linssen, Catharina F M</creator><creator>van Dessel, Helke A</creator><creator>Bergmans, Dennis C J J</creator><creator>Savelkoul, Paul H M</creator><creator>Roekaerts, Paul M H J</creator><creator>van Mook, Walther N K A</creator><general>BioMed Central Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20150812</creationdate><title>Ventilator-associated Pneumonia caused by commensal oropharyngeal Flora; [corrected] a retrospective Analysis of a prospectively collected Database</title><author>Scholte, Johannes B J ; van der Velde, Johan I M ; Linssen, Catharina F M ; van Dessel, Helke A ; Bergmans, Dennis C J J ; Savelkoul, Paul H M ; Roekaerts, Paul M H J ; van Mook, Walther N K A</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c256y-5aa1c697f1142cc8495ba0404dd277970bd852ff57d5c67b08e17db3dcbccc183</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Analysis</topic><topic>Bacteria - isolation & purification</topic><topic>Bacterial pneumonia</topic><topic>Bronchoalveolar Lavage Fluid - microbiology</topic><topic>Care and treatment</topic><topic>Development and progression</topic><topic>Diagnosis</topic><topic>Female</topic><topic>Health aspects</topic><topic>Hospital Mortality - trends</topic><topic>Hospital patients</topic><topic>Humans</topic><topic>Incidence</topic><topic>Intensive Care Units</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Netherlands - epidemiology</topic><topic>Oropharynx - microbiology</topic><topic>Patient outcomes</topic><topic>Pneumonia</topic><topic>Pneumonia, Ventilator-Associated - diagnosis</topic><topic>Pneumonia, Ventilator-Associated - epidemiology</topic><topic>Pneumonia, Ventilator-Associated - microbiology</topic><topic>Respiration, Artificial - adverse effects</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Scholte, Johannes B J</creatorcontrib><creatorcontrib>van der Velde, Johan I M</creatorcontrib><creatorcontrib>Linssen, Catharina F M</creatorcontrib><creatorcontrib>van Dessel, Helke A</creatorcontrib><creatorcontrib>Bergmans, Dennis C J J</creatorcontrib><creatorcontrib>Savelkoul, Paul H M</creatorcontrib><creatorcontrib>Roekaerts, Paul M H J</creatorcontrib><creatorcontrib>van Mook, Walther N K A</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>BMC pulmonary medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Scholte, Johannes B J</au><au>van der Velde, Johan I M</au><au>Linssen, Catharina F M</au><au>van Dessel, Helke A</au><au>Bergmans, Dennis C J J</au><au>Savelkoul, Paul H M</au><au>Roekaerts, Paul M H J</au><au>van Mook, Walther N K A</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Ventilator-associated Pneumonia caused by commensal oropharyngeal Flora; [corrected] a retrospective Analysis of a prospectively collected Database</atitle><jtitle>BMC pulmonary medicine</jtitle><addtitle>BMC Pulm Med</addtitle><date>2015-08-12</date><risdate>2015</risdate><volume>15</volume><issue>1</issue><spage>86</spage><epage>86</epage><pages>86-86</pages><artnum>86</artnum><issn>1471-2466</issn><eissn>1471-2466</eissn><abstract>The significance of commensal oropharyngeal flora (COF) as a potential cause of ventilator-associated pneumonia (VAP) is scarcely investigated and consequently unknown. Therefore, the aim of this study was to explore whether COF may cause VAP.
Retrospective clinical, microbiological and radiographic analysis of all prospectively collected suspected VAP cases in which bronchoalveolar lavage fluid exclusively yielded ≥ 10(4) cfu/ml COF during a 9.5-year period. Characteristics of 899 recent intensive care unit (ICU) admissions were used as a reference population.
Out of the prospectively collected database containing 159 VAP cases, 23 patients were included. In these patients, VAP developed after a median of 8 days of mechanical ventilation. The patients faced a prolonged total ICU length of stay (35 days [P < .001]), hospital length of stay (45 days [P = .001]), and a trend to higher mortality (39 % vs. 26 %, [P = .158]; standardized mortality ratio 1.26 vs. 0.77, [P = .137]) compared to the reference population. After clinical, microbiological and radiographic analysis, COF was the most likely cause of respiratory deterioration in 15 patients (9.4 % of all VAP cases) and a possible cause in 2 patients.
Commensal oropharyngeal flora appears to be a potential cause of VAP in limited numbers of ICU patients as is probably associated with an increased length of stay in both ICU and hospital. As COF-VAP develops late in the course of ICU admission, it is possibly associated with the immunocompromised status of ICU patients.</abstract><cop>England</cop><pub>BioMed Central Ltd</pub><pmid>26264828</pmid><doi>10.1186/s12890-015-0087-y</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Analysis Bacteria - isolation & purification Bacterial pneumonia Bronchoalveolar Lavage Fluid - microbiology Care and treatment Development and progression Diagnosis Female Health aspects Hospital Mortality - trends Hospital patients Humans Incidence Intensive Care Units Male Middle Aged Netherlands - epidemiology Oropharynx - microbiology Patient outcomes Pneumonia Pneumonia, Ventilator-Associated - diagnosis Pneumonia, Ventilator-Associated - epidemiology Pneumonia, Ventilator-Associated - microbiology Respiration, Artificial - adverse effects Retrospective Studies Risk Factors |
| title | Ventilator-associated Pneumonia caused by commensal oropharyngeal Flora; [corrected] a retrospective Analysis of a prospectively collected Database |
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