Data/hora: 11/06/2024 08:06:07

Provedor de dados: 	55	
País: 	Brazil	
Título: 	Control of multi-resistant bacteria and ventilator-associated pneumonia: is it possible with changes in antibiotics?	
Autores: 	Jukemura,Elisa M.; Burattini,Marcelo N.; Pereira,Carlos A.P.; Braga,Alfésio L.F.; Medeiros,Eduardo A.S.	
Data: 	2007-08-01	
Ano: 	2007	
Palavras-chave: 	Ventilator associated pneumonia; Multi-resistant bacteria; Infection control.	
Resumo: 	Potent antimicrobial agents have been developed as a response to the development of antibiotic-resistant bacteria, which especially affect patients with prolonged hospitalization in Intensive Care Units (ICU) and who had been previously treated with antimicrobials, especially third-generation cephalosporins.This study was to determine how changes in the empirical treatment of infections in ICU patients affect the incidence of Gram-negative bacteria species and their susceptibility to antimicrobials, and examine the impact of these changes on nosocomial infections. A prospective interventional study was performed in a university hospital during two periods: 1) First period (September 1999 to February 2000); and 2) Second period (August 2000 to December 2000); empirical treatment was changed from ceftriaxone and/or ceftazidime in the first period to piperacillin/tazobactam in the second. ICU epidemiological and infection control rates, as well as bacterial isolates from upper airways were analyzed. Ceftazidime consumption dropped from 34.83 to 0.85 DDD/1000 patients per day (p=0.004). Piperacillin/tazobactam was originally not available; its consumption reached 157.07 DDD/1000 patients per day in the second period (p=0.0002). Eighty-seven patients and 66 patients were evaluated for upper airway colonization in the first and second periods, respectively. There was a significant decrease in the incidence of K. pneumoniae (p=0.004) and P. mirabilis (p=0.036), restoration of K. pneumoniae susceptibility to cephalosporins (p&lt;0.0001) and reduction of ventilator-associated pneumonia rates (p&lt;0.0001). However, there was an increase in P. aeruginosa incidence (p=0.005) and increases in ceftazidime (p=0.003) and meropenem (p&lt;0.0001) susceptibilities. Changing antimicrobial selective pressure on multi-resistant Gram-negative bacteria helps control ventilator-associated pneumonia and decreases antimicrobial resistance.	
Tipo: 	Info:eu-repo/semantics/article	
Idioma: 	Inglês	
Identificador: 	http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702007000400010	
Editor: 	Brazilian Society of Infectious Diseases	
Relação: 	10.1590/S1413-86702007000400010	
Formato: 	text/html	
Fonte: 	Brazilian Journal of Infectious Diseases  v.11 n.4 2007	
Fonte: 	info:eu-repo/semantics/openAccess