التفاصيل البيبلوغرافية
| العنوان: |
Prevention of gram negative nosocomial bronchopneumonia by intratracheal colistin in critically ill patients. Histologic and bacteriologic study. |
| المؤلفون: |
Rouby, J., Poète, P., Martin de Lassale, E., Nicolas, M., Bodin, L., Jarlier, V., Korinek, A., Viars, P., Rouby, J J, Poète, P, Nicolas, M H, Korinek, A M |
| المصدر: |
Intensive Care Medicine; Mar1994, Vol. 20 Issue 3, p187-192, 6p |
| مصطلحات موضوعية: |
PNEUMONIA diagnosis, PNEUMONIA prevention, CROSS infection prevention, COLISTIN, ARTIFICIAL respiration, BODY fluids, CATASTROPHIC illness, CLINICAL trials, CROSS infection, DRUG resistance in microorganisms, DRUG administration, CLINICAL drug trials, LONGITUDINAL method, GRAM-negative bacterial diseases, MICROBIAL sensitivity tests, PNEUMONECTOMY, PNEUMONIA, SURVIVAL, TRACHEA intubation, DISEASE incidence, PREVENTION, DIAGNOSIS, THERAPEUTICS |
| مستخلص: |
Objective: To evaluate the efficiency of intratracheal colistin in preventing nosocomial bronchopneumonia (BPN) in the critically ill.Design: Study evaluating the clinical incidence of nosocomial BPN in 2 groups of critically ill patients who receive or did not receive intratracheal colistin. BPN was assessed clinically in survivors and histologically in non-survivors.Setting: A 14-bed surgical intensive care unit.Patients: 598 consecutive critically ill patients were studied during a prospective non-randomized study over a 40-month period.Interventions: 251 patients--31 non-survivors and 220 survivors--did not receive intratracheal colistin and 347-42 non-survivors and 305 survivors--received intratracheal colistin for a 2-week period (1,600,000 units per 24 h).Measurements and Results: The incidence of nosocomial BPN was evaluated clinically in survivors, using repeated protected minibronchoalveolar lavages, and histologically in non-survivors via an immediate postmortem pneumonectomy (histologic and semi-quantitative bacteriologic analysis of one lung). The clinical incidence of nosocomial BPN was of 37% in coli (-) survivors and of 27% in coli (+) survivors (p < 0.01). This result was histologically confirmed in non-survivors, where the incidence of histologic BPN was of 61% in coli (-) patients and of 36% in coli (+) patients (p < 0.001). Emergence of BPN due to colistin-resistant micro-organisms was not observed. Because colistin was successful in preventing Gram-negative BPN and did not change the absolute number of Gram-positive BPN, the proportion of BPN caused by staphylococcus species was higher in group coli (+) patients (33% vs 16%). Mortality was not significantly influenced by the administration of colistin.Conclusion: This study suggests that the administration of intratracheal colistin during a 2-week period significantly reduces the incidence of Gram-negative BPN without creating an increasing number of BPN due to colistin-resistant micro-organisms. [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: |
Complementary Index |
