In:
Respiration, S. Karger AG, Vol. 68, No. 1 ( 2001), p. 58-66
Abstract:
〈 i 〉 Background: 〈 /i 〉 Colonization is an important risk factor for consecutive infection, but little is known about incidence and initial pattern on admission to respiratory intensive care units (RICU). 〈 i 〉 Objective: 〈 /i 〉 To study the bacterial colonization during the first 24 h after admission to a RICU. 〈 i 〉 Methods: 〈 /i 〉 Endotracheal aspirates, gastric juice, and pharyngeal and rectal swabs of 55 consecutive patients were cultured (45 men, age 66 ± 14 years, APACHE II 20.1 ± 5.6, no parenchymal infection). All samples were taken within the first 24 h after admission to a RICU. Potentially pathogenic microorganisms were grouped as community (c-PPM) and hospital acquired (h-PPM), and risk factors for colonization of each body site as well as for overall colonization (all sites excluding rectum) were identified by logistic regression analysis. 〈 i 〉 Results: 〈 /i 〉 The trachea was colonized in 18% of the intubated patients with c-PPMs and in 11% with h-PPMs. 〈 i 〉 Candida 〈 /i 〉 spp. were the most frequent c-PPMs isolated from trachea, pharynx, and stomach (excluding rectal swabs), and 〈 i 〉 Pseudomonas aeruginosa 〈 /i 〉 was the most frequently isolated h-PPM in trachea. The incidence of overall colonization was 49% for c-PPMs (predominantly 〈 i 〉 Escherichia coli 〈 /i 〉 ) and 18% for h-PPMs (predominantly 〈 i 〉 P. aeruginosa 〈 /i 〉 ). Admission to the hospital ≧48 h before ICU admission was an independent risk factor of colonization with h-PPMs in univariate (33 vs. 7%, p = 0.015) and multivariate analyses (odds ratio 7.2, 95% CI 1.4–38.3; p = 0.0197). 〈 i 〉 Conclusions: 〈 /i 〉 Colonization of the trachea with c-PPMs was already present in every 5th and with h-PPMs in every 10th intubated patient during the first 24 h of RICU admission even in the absence of parenchymal infections. Hospitalization more than 48 h prior to RICU admission was a risk factor of colonization with h-PPMs.
Type of Medium:
Online Resource
ISSN:
0025-7931
,
1423-0356
Language:
English
Publisher:
S. Karger AG
Publication Date:
2001
detail.hit.zdb_id:
1464419-8
