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Incidence of nosocomial pneumonia and risk of recurrence after antimicrobial therapy in critically ill lung and heart–lung transplant patients
Author(s) -
Dudau Daniela,
Camous Julien,
Marchand Séverine,
Pilorge Catherine,
RézaiguiaDelclaux Saïda,
Libert JeanMarie,
Fadel Elie,
Stéphan François
Publication year - 2014
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.12270
Subject(s) - medicine , pneumonia , lung transplantation , lung , incidence (geometry) , ventilator associated pneumonia , bronchoalveolar lavage , transplantation , surgery , physics , optics
Little is known about the resolution of symptoms of nosocomial pneumonia ( N oso P ) after lung and heart–lung transplantation. The aim of this study was to describe the clinical response to antimicrobial therapy in ( ICU ) patients with N oso P after lung or heart–lung transplantation. Between January 2008 and A ugust 2010, 79 lung or heart–lung transplantations patients were prospectively studied. N oso P was confirmed by quantitative cultures of bronchoalveolar lavage or endotracheal aspirates. Clinical variables, sequential organ failure assessment ( SOFA ) score, and radiologic score were recorded from start of therapy until day 9. Thirty‐five patients (44%) experienced 64 episodes of N oso P in ICU . Fourteen patients (40%) had N oso P recurrence. Most frequently isolated organisms were E nterobacteriaceae (30%), P seudomonas aeruginosa (25%), and S taphylococcus aureus (20%). Sequential organ failure assessment ( SOFA ) score improved significantly at day 6 and C‐reactive protein level at day 9. SOFA and radiologic scores differed significantly between patients with and without NosoP recurrence at day 3 and 9. The ICU mortality rate did not differ between patients with and without N oso P recurrence, and free of N oso P (14.3%, 9.5%, 11.4%, respectively) (p = 0.91). Severities of illness and lung injury were the two major risk factors for N oso P recurrence. Occurrence of N oso P has no impact on ICU mortality.