Effect of Aerosolized Colistin as Adjunctive Treatment on the Outcomes of Microbiologically Documented Ventilator-Associated Pneumonia Caused by Colistin-Only Susceptible Gram-Negative Bacteria

粘菌素 医学 呼吸机相关性肺炎 鲍曼不动杆菌 肺炎 内科学 铜绿假单胞菌 机械通风 队列 感染性休克 多粘菌素 不动杆菌 回顾性队列研究 微生物学 抗生素 败血症 细菌 遗传学 生物
作者
Mario Tumbarello,Gennaro De Pascale,Enrico Maria Trecarichi,Salvatore De Martino,Giuseppe Bello,Riccardo Maviglia,Teresa Spanu,Massimo Antonelli
出处
期刊:Chest [Elsevier]
卷期号:144 (6): 1768-1775 被引量:167
标识
DOI:10.1378/chest.13-1018
摘要

The increasing frequency of ventilator-associated pneumonia (VAP) caused by colistin-only susceptible (COS) gram-negative bacteria (GNB) is of great concern. Adjunctive aerosolized (AS) colistin can reportedly increase alveolar levels of the drug without increasing systemic toxicity. Good clinical results have been obtained in patients with cystic fibrosis, but conflicting data have been reported in patients with VAP.We conducted a retrospective, 1:1 matched case-control study to evaluate the efficacy and safety of AS plus IV colistin vs IV colistin alone in 208 patients in the ICU with VAP caused by COS Acinetobacter baumannii, Pseudomonas aeruginosa, or Klebsiella pneumoniae.Compared with the IV colistin cohort, the AS-IV colistin cohort had a higher clinical cure rate (69.2% vs 54.8%, P = .03) and required fewer days of mechanical ventilation after VAP onset (8 days vs 12 days, P = .001). In the 166 patients with posttreatment cultures, eradication of the causative organism was also more common in the AS-IV colistin group (63.4% vs 50%, P = .08). No between-cohort differences were observed in all-cause ICU mortality, length of ICU stay after VAP onset, or rates of acute kidney injury (AKI) during colistin therapy. Independent predictors of clinical cure were trauma-related ICU admission (P = .01) and combined AS-IV colistin therapy (P = .009). Higher mean Simplified Acute Physiology Score II (P = .002) and Sequential Organ Failure Assessment (P = .05) scores, septic shock (P < .001), and AKI onset during colistin treatment (P = .04) were independently associated with clinical failure.Our results suggest that AS colistin might be a beneficial adjunct to IV colistin in the management of VAP caused by COS GNB.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
lily88发布了新的文献求助10
1秒前
2632216834完成签到 ,获得积分10
1秒前
yangxuwen99完成签到,获得积分10
2秒前
Frank完成签到,获得积分10
2秒前
pdf发布了新的文献求助10
3秒前
july九月完成签到,获得积分10
3秒前
3秒前
zhangxr发布了新的文献求助10
4秒前
zhou完成签到,获得积分10
4秒前
xu应助取名叫做利采纳,获得10
4秒前
4秒前
听话的念柏完成签到,获得积分20
4秒前
江苏吴世勋完成签到,获得积分10
5秒前
自信的如冰完成签到,获得积分10
5秒前
lay完成签到,获得积分10
5秒前
NexusExplorer应助心碎小文采纳,获得10
6秒前
谙晴发布了新的文献求助10
7秒前
阿达达瓦完成签到,获得积分20
8秒前
科研通AI5应助诚心绿兰采纳,获得10
9秒前
FashionBoy应助奔波儿灞采纳,获得10
9秒前
11111发布了新的文献求助10
10秒前
10秒前
jebert完成签到,获得积分10
11秒前
猫咪也疯狂应助XIAONAN采纳,获得10
11秒前
丘比特应助visetone采纳,获得10
11秒前
ZYQ完成签到 ,获得积分10
11秒前
12秒前
12秒前
14秒前
领导范儿应助lily88采纳,获得30
14秒前
翎尧发布了新的文献求助10
14秒前
15秒前
16秒前
自信的伊完成签到,获得积分20
16秒前
16秒前
pbj完成签到,获得积分10
16秒前
柠A发布了新的文献求助10
17秒前
科研通AI2S应助Kannan采纳,获得10
17秒前
18秒前
在水一方应助pipipi采纳,获得10
18秒前
高分求助中
Continuum Thermodynamics and Material Modelling 3000
Production Logging: Theoretical and Interpretive Elements 2700
Les Mantodea de Guyane Insecta, Polyneoptera 1000
Conference Record, IAS Annual Meeting 1977 820
England and the Discovery of America, 1481-1620 600
Teaching language in context (Third edition) by Derewianka, Beverly; Jones, Pauline 550
Typology of Conditional Constructions 500
热门求助领域 (近24小时)
化学 材料科学 生物 医学 工程类 有机化学 生物化学 物理 纳米技术 计算机科学 内科学 化学工程 复合材料 基因 遗传学 物理化学 催化作用 量子力学 光电子学 冶金
热门帖子
关注 科研通微信公众号,转发送积分 3584384
求助须知:如何正确求助?哪些是违规求助? 3153406
关于积分的说明 9496882
捐赠科研通 2856006
什么是DOI,文献DOI怎么找? 1569829
邀请新用户注册赠送积分活动 735673
科研通“疑难数据库(出版商)”最低求助积分说明 721336