Original scientific paper

Microbial Profile and Antibiotic Susceptibility Patterns of Pathogens Causing Ventilator-Associated Pneumonia at Intensive Care Unit, Sestre Milosrdnice University Hospital Center, Zagreb, Croatia

Tihana Magdić Turković orcid.org/0000-0003-1193-512X ; Department of Anesthesiology and Intensive Care, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
Ana Gverić Grginić ; Department of Microbiology, Parasitology and Hospital Infections, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
Branka Đuras Cuculić ; Department of Microbiology, Parasitology and Hospital Infections, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
Božena Gašpar ; Department of Surgery, Nova Gradiška General Hospital, Nova Gradiška, Croatia
Mladen Širanović ; Department of Anesthesiology and Intensive Care, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
Mladen Perić ; Department of Anesthesiology and Resuscitation, School of Medicine, University of Zagreb, Zagreb, Croatia

Abstract

Ventilator-associated pneumonia (VAP) is very common in many intensive care Units, but there are still many uncertainties about VAP, especially about the choice of initial empiric antibiotics. The incidence of specific pathogens with different susceptibility patterns causing VAP varies from hospital to hospital. This is the reason why empiric initial antibiotic treatment for VAP should be based not only on general guidelines (that recommend therapy according to the presence of risk factors for multidrug-resistant bacteria), but also on up-to-date information on local epidemiology. The aim of this study was to determine the microbial profile of pathogens causing VAP and their antibiotic susceptibility patterns. The study was conducted in the 15-bed surgical and neurosurgical Intensive Care Unit, Department of Anesthesiology and Intensive Care, Sestre milosrdnice University Hospital Center, Zagreb, Croatia. Retrospective data were collected from September 2009 to March 2013. All patients that developed VAP during the study period were eligible for the study. According to study results, the incidence of VAP was 29.4%. The most commonly isolated bacterium was Staphylococcus aureus (21.1%), followed by Pseudomonas aeruginosa (19.0%) and Acinetobacter species (13.6%). All Staphylococcus aureus isolates were susceptible to vancomycin and linezolid. Pseudomonas aeruginosa showed 100% susceptibility to cefepime and very high susceptibility to piperacillin-tazobactam (96%), ceftazidime (93%) and ciprofloxacin (89%). Ampicillin-sulbactam was highly effective for Acinetobacter species, showing resistance in only 8% of isolates. In conclusion, according to study data, appropriate empiric antibiotic therapy for patients with VAP without risk factors for multidrug-resistant bacteria is ceftriaxone and for patients with risk factors for multidrug-resistant bacteria ampicillin-sulbactam plus cefepime plus vancomycin or linezolid.

Keywords

Pneumonia, ventilator-associated – etiology; Drug resistance, microbial; Intensive care units; Croatia

Hrčak ID:

145184

URI

https://hrcak.srce.hr/145184

Publication date:

1.7.2015.

Article data in other languages: croatian

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