Healthcare-associated infections: Appropriate empirical antibiotic treatment

Health-care Associated Infections (HAI) are one of the main causes of death in critically ill patients. The aim of this paper is to establish an appropriate empirical antibiotic treatment for the main HAI in an Intensive Care Unit (ICU).

A retrospective, observational, descriptive and analytical study of the culture results from January, 2014 to December, 2015. The causative microorganisms were identified, as well as sensitivity and antibiotic resistance.

Of the three main HAI in the ICU were Ventilator Associated Pneumonia (VAP), whose most common germs were methicillin-resistant Staphylococcus aureus, Acinetobacter baumannii, Pseudomonas aeruginosa; Urinary Tract Infection Associated with Urinary Catheter (IVU-CU), Escherichia coli BLEE and Pseudomonas aeruginosa were isolated in 70%, and 56% of the bloodstream infections of the germs that caused this infection were three, the most frequent being Escherichia coli, followed by Klebsiella oxytoca and methicillin-resistant Staphylococcus aureus.

VAP was the most frequent HAI and resistant methicillin Staphylococcus aureus was the most prevalent in this type of infection. The proposed empiric antibiotic treatment was as follows: VAP (vancomycin plus amikacin plus meropenem), IVU-CU (meropenem) and STIs (vancomycin plus cefepime).