| Comparison of the Bacterial Etiology of Early-Onset Ventilator Associated Pneumonia and Late-Onset Ventilator Associated Pneumonia in Subjects Enrolled in 2 Large Clinical Studies. | |
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MedLine Citation:
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PMID: 23307825 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Purpose:To assess potential differences in bacterial etiology of subjects with early-onset vs. late-onset ventilator associated pneumonia (VAP).Methods:Subjects enrolled in 2004-2006 in 2 clinical studies of doripenem vs. imipenem or piperacillin/tazobactam with a diagnosis of VAP (N=500) were included in the analysis. Subjects were classified by ventilator status [early-onset VAP (<5 days of ventilation) or late-onset VAP (≥5 days of ventilation)]. Baseline demographics and bacterial etiology were analyzed by VAP status.Results:Late-onset VAP subjects had higher APACHE II scores [mean 16.6 vs. 15.5 (p=0.008)]. There were no significant differences in CPIS, gender, age, or presence of bacteremia between groups. A total of 496 subjects had a baseline pathogen and 50% of subjects in each group had ≥2 pathogens. With the exception of Staphylococcus aureus, which was common in early-onset VAP, pathogens, including potentially MDR, isolated from early vs. late-onset VAP was not significantly different between groups. Acinetobacter baumannii or Pseudomonas aeruginosa with decreased susceptibility to any study drug was observed in early and late onset VAP subjects.Conclusion:There were no significant differences in the prevalence of potential MDR pathogens associated with early or late-onset VAP, even in subjects with prior antibiotics.Clinical Implications:VAP is classified as early-onset or late-onset, in part, to identify subjects at risk for infection with resistant pathogens. Empiric therapy for early-onset VAP should also include agents likely to be effective for potential MDR pathogens. Further prospective studies should evaluate microbiology trends in subjects with VAP. |
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Authors:
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Marcos I Restrepo; Janet Peterson; Juan F Fernandez; Zhihai Qin; Alan C Fisher; Susan C Nicholson |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2013-1-9 |
Journal Detail:
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Title: Respiratory care Volume: - ISSN: 0020-1324 ISO Abbreviation: Respir Care Publication Date: 2013 Jan |
Date Detail:
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Created Date: 2013-1-11 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7510357 Medline TA: Respir Care Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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VERDICT (MIR), South Texas Veterans Health Care System Audie L Murphy Division (MIR); the University of Texas Health Science Center at San Antonio, Department of Medicine, Division of Pulmonary and Critical Care Medicine (MIR, JFF); Janssen Scientific Affairs, (JP, ZQ, ACF, SCN) Janssen Scientific Affairs LLC, 1000 Rt 202s Raritan, NJ 08869. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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