Document Detail


Severe ventilator-associated pneumonia caused by methicillin-resistant Staphylococcus aureus and other pathogens: report of a case successfully managed by serial surveillance cultures of endotracheal aspirates.
MedLine Citation:
PMID:  20862506     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Severe ventilator-associated pneumonia (VAP) caused by methicillin-resistant Staphylococcus aureus (MRSA) developed in a patient with acute respiratory distress syndrome. After tracheostomy, the patient was treated with antibiotic therapy guided by serial surveillance cultures of endotracheal aspirates. According to the result of the culture, the suitable antibiotic targeting the pathogen (e.g., MRSA, Pseudomonas aeruginosa, Klebsiella oxytoca) that had grown most predominantly in the culture was used until clinical resolution of VAP, leading to avoidance of overusing broad-spectrum antibiotics and ultimately a favorable outcome. During vancomycin (VCM) therapy for MRSA VAP, MRSA bacteremia occurred even though the trough value of VCM was sufficiently high. After the change from VCM to linezolid (LZD), the VAP improved promptly, indicating that LZD is superior to VCM in the treatment of MRSA pneumonia.
Authors:
Chikara Sakai; Hiroaki Soda
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Publication Detail:
Type:  Journal Article     Date:  2010-09-23
Journal Detail:
Title:  Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy     Volume:  17     ISSN:  1437-7780     ISO Abbreviation:  J. Infect. Chemother.     Publication Date:  2011 Jun 
Date Detail:
Created Date:  2011-06-09     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9608375     Medline TA:  J Infect Chemother     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  424-8     Citation Subset:  IM    
Affiliation:
Division of Hematology-Oncology and Infection Control Team, Chiba Cancer Center Hospital, 666-2 Nitona-cho, Chuo-ku, Chiba, 260-8717, Japan, chisakai@chiba-cc.jp.
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