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Polymicrobial intensive care unit-acquired pneumonia: prevalence, microbiology and outcome

Miquel Ferrer1,2,3, Leonardo Filippo Difrancesco4,5, Adamantia Liapikou6,7

  • 1Department of Pneumology, Thorax Institute, Hospital Clinic, Villarroel 170, 08036, Barcelona, Spain. miferrer@clinic.ub.es.

Critical Care (London, England)
|December 26, 2015
PubMed
Abstract

Insights

Polymicrobial intensive care unit-acquired pneumonia (ICUAP) occurs in 16% of cases. When treated appropriately, polymicrobial ICUAP does not significantly impact patient outcomes compared to monomicrobial cases.

Area of Science:

  • Infectious Diseases
  • Critical Care Medicine
  • Microbiology

Background:

  • Microbial etiology of intensive care unit-acquired pneumonia (ICUAP) is crucial for guiding antibiotic therapy and predicting patient outcomes.
  • The clinical characteristics and impact of polymicrobial ICUAP remain incompletely understood.
  • This study aimed to investigate the features and outcomes associated with polymicrobial ICUAP.

Purpose of the Study:

  • To characterize polymicrobial ICUAP.
  • To compare clinical features, microbiology, and outcomes of polymicrobial versus monomicrobial ICUAP.
  • To determine if polymicrobial etiology affects ICUAP outcomes.

Main Methods:

  • Prospective comparison of ICUAP patients with microbiologically confirmed monomicrobial or polymicrobial infections.
  • Exclusion of non-pathogenic microorganisms from etiologic diagnosis.
  • Assessment of clinical data, microbial findings, inflammatory markers, and patient outcomes.

Main Results:

  • Of 256 microbiologically confirmed ICUAP cases, 16% were polymicrobial.
  • Polymicrobial pneumonia was associated with more frequent pleural effusion and less frequent chronic heart disease.
  • Appropriate empiric antimicrobial treatment, initial response, length of stay, and mortality were similar between monomicrobial and polymicrobial groups.

Conclusions:

  • Polymicrobial infections account for 16% of microbiologically confirmed ICUAP.
  • Pleural effusion and absence of chronic heart disease are linked to polymicrobial ICUAP.
  • Appropriate empiric treatment ensures that polymicrobial etiology does not negatively influence ICUAP outcomes.

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