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Assessment of severity of ICU-acquired pneumonia and association with etiology

Marta Di Pasquale1, Miquel Ferrer, Mariano Esperatti

  • 11Servei de Pneumologia, Institut del Torax, Hospital Clinic, IDIBAPS, Universitat de Barcelona, Barcelona, Spain. 2Centro de Investigación Biomedica En Red-Enfermedades Respiratorias, Bunyola, Spain. 3Department of Pathophysiology and Transplantation, Università degli Studi di Milano, IRCCS Fondazione Ospedale Maggiore Policlinico Cà Granda, Milano, Italy. 4Department of Pulmonary Rehabilitation, Ospedale Villa Pineta, Pavullo nel Frignano, Modena, Italy. 5Department of Medicine, Winthrop University Hospital, Mineola, NY.

Critical Care Medicine
|August 31, 2013
PubMed
Abstract

Insights

Severity of illness does not appear to influence the cause of ICU-acquired pneumonia. Clinicians should prioritize risk factors for multidrug-resistant pathogens over illness severity when choosing initial antibiotic treatments.

Area of Science:

  • Infectious Diseases
  • Critical Care Medicine
  • Microbiology

Background:

  • ICU-acquired pneumonia presents a significant challenge in critical care settings.
  • Determining the microbial etiology is crucial for effective treatment.
  • The role of illness severity in guiding empiric antibiotic selection for ICU-acquired pneumonia remains unclear.

Purpose of the Study:

  • To evaluate the association between the severity of illness and the microbial etiology of ICU-acquired pneumonia.
  • To determine if illness severity should guide empiric antibiotic choices in these patients.

Main Methods:

  • Prospective observational study conducted in university hospital ICUs.
  • Included 343 consecutive patients with ICU-acquired pneumonia.
  • Etiology was determined in 63% of patients, with a focus on multidrug-resistant pathogens.

Main Results:

  • Pseudomonas aeruginosa, Enterobacteriaceae, and Staphylococcus aureus were the most frequent pathogens.
  • Multidrug-resistant pathogens were identified in 17% of patients.
  • No significant differences in clinical characteristics, severity, or mortality were found between patients with and without multidrug-resistant pathogens, except for longer ICU stay and microbial persistence in the MDR group.

Conclusions:

  • Illness severity does not appear to influence the microbial etiology of ICU-acquired pneumonia.
  • Risk factors for multidrug-resistant pathogens, rather than illness severity, should guide empiric antimicrobial treatment decisions.

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