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Journal of Intensive Care Medicine, Vol. 18, No. 5, 269-274 (2003)
DOI: 10.1177/0885066603256012

Ventilator-Associated Pneumonia Patients who Do Not Reduce Bacteria from the Lungs have a Worse Prognosis

Robert P. Baughman, MD

University of Cincinnati Medical Center, Cincinnati, OH, bob.baughman{at}uc.edu

Marie A. Kerr

University of Cincinnati Medical Center, Cincinnati, OH

The authors determined the significance of serial semi-quantitative bronchoalveolar lavage (BAL) culture results in patients undergoing therapy for ventilator-associated pneumonia. A total of 32 patients underwent at least 2 nonbronchoscopic BAL studies. Fourteen patients had methicillin-resistant Staphylococcus aureus (MRSA). Of these, 11 had more than 100 colony-forming units (cfu) of MRSA/mL of BAL from the follow-up BAL. Eighteen patients had an organism other than MRSA, and 7 of these patients had > 100 cfu of bacteria/mL of BAL from the follow-up BAL. Of the 18 patients with > 100 cfu of bacteria/mL of BAL at follow-up, 14 (79%) died, whereas only 5 of 14 (36%) patients who cleared their bacteria at follow-up died within 28 days. The inability to reduce the bacterial burden from the lower respiratory tract within the first few days of therapy for ventilator-associated pneumonia was associated with increased mortality.

Key Words: methicillin-resistant • S. aureus • Staphylcoccus aureus • vancomycin • bronchoalveolar lavage


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