Abstract
Pseudomonas aeruginosa is the causative organism in 16% to 31% of reported cases of ventilator-associated pneumonia (VAP). Despite the availability of potent antimicrobials and the facilities offered by the intensive care unit, the associated overall mortality is approximately 70%, with an excess mortality of more than 40%. By these observation alone, P. aeruginosa pneumonia represents one of the most serious clinical problems facing the intensive care clinician today. This article includes a review of epidemiology, risk factors for infection, diagnosis and treatment, together with a discussion of predictors of mortality. Summary data from a study of 35 patients with P. aeruginosa VAP in the Oxford ICU are presented. In the search for more effective combinations of available antibiotics we have treated 12 patients with nebulised colistin in conjunction with standard anti-pseudomonal parenteral agents. We present data from this pilot study, including outcome compared to a historical control group. Major improvements in outcome may not be realised until novel therapeutic strategies are developed. The forerunner to this is the acquisition of an indepth understanding of bacterial mechanisms in disease. This overview, therefore, also includes data from some areas of research which shed light on bacterial pathogenesis as a cellular and molecular level.
Translated title of the contribution | Ventilator-associated Pseudomonas aeruginosa pneumonia |
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Original language | German |
Pages (from-to) | 316-324 |
Number of pages | 9 |
Journal | Intensivmedizin und Notfallmedizin |
Volume | 35 |
Issue number | 5 |
DOIs | |
Publication status | Published - Jun 1998 |
Externally published | Yes |
Keywords
- Pneumonia
- Pseudomonas aeroginosa
- Ventilator-associated