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A Delayed Inoculation Model of Chronic Pseudomonas aeruginosa Wound Infection
Published on: February 20, 2020
Does invasive diagnosis of nosocomial pneumonia during off-hours delay treatment?
Charles-Edouard Luyt1, Alain Combes, Ania Nieszkowska
1Université Pierre et Marie Curie, Service de Réanimation Médicale, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, 47 Boulevard de l'Hôpital, 75651, Paris Cedex 13, France. charles-edouard.luyt@psl.aphp.fr
Objective:
We examined whether invasive lung-specimen collection-to-treatment times for intensive care unit patients with suspected ventilator-associated pneumonia (VAP) differ with to the work shift during which specimens were collected. We compared weekday day shifts and off-hours (from 6:30 p.m. to 8:29 a.m. the next day for night shifts, from Saturday 1:00 p.m. to Monday 8:29 a.m. for weekends, and from 8:30 a.m. to 8:29 a.m. the following morning for public holidays).
Design And Setting:
Single-center, observational study in the intensive care unit in an academic teaching hospital.
Patients And Participants:
101 patients who developed 152 episodes of bacteriologically confirmed VAP.
Measurements And Results:
Of the 152 VAP episodes 66 were diagnosed during off-hours. Neither more bronchoscopy complications nor more inappropriate initial antimicrobial treatments for patients were observed between day and off-hour shifts. Indeed, the overall time from brochoalveolar lavage to antibiotic administration was shorter for off-hours than day-shifts due to shorter specimen collection-to-antibiotic prescription times, but antibiotic prescription-to-administration times were the same.
Conclusions:
An invasive strategy based on bronchoscopy to diagnose VAP was not associated with a longer time to first appropriate antibiotic administration when clinical suspicion of VAP occurs during off-hours.
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