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Klebsiella pneumoniae (K. pneumoniae) and Acinetobacter baumannii (A. baumannii) are multiresistant pathogens most frequently found in patients hospitalized in the Intensive Care of our hospital. We found the highest rate of positivity in the bronchial aspirates, often followed by a similar observation in blood culture. We carried out a study to evaluate the reduction of sepsis that developed after the detection of these microorganisms in bronchial aspirate, following the introduction of treatment with colistin aerosol in combination with conventional therapy. From 2012 to the first half of 2014, 533 patients were admitted to the ICU of our hospital. Since May 2013, colistin was administered by aerosol along with conventional therapy. In 43 (78.1%) cases K. pneumoniae KPC was isolated from bronchial aspirate and in 30 (54.5%) from blood culture; MDR A. baumannii was isolated in 89 (96.7%) cases of bronchial aspirate and 45 (48.9%) from blood culture. From patients treated with added colistin aerosol, K. pneumoniae KPC was isolated from bronchial aspirates in 15 cases and in 4 (26.7%) of those was found sepsis. MDR A. baumannii was isolated from bronchial aspirate in 41 cases, and in 10 (24.4%) it developed sepsis due to the same germ. The patients admitted to intensive care for more than 7 days were positive for MDR A. baumannii and MDR K. pneumoniae in bronchial aspirates and subsequent relief of blood culture. The treatment with colistin aerosol resulted in a reduction of the spread of microorganisms from the lower respiratory tract to the blood.

international journal of critical care and emergency medicine

Relationship Between Isolating Multi-Drug Resistant A. Baumannii and K. Pneumoniae in Bronchial Aspirate and Subsequently in Blood Cultures: Evaluation of Colistin Aerosol Therapy in Intensive Care Patients