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Evaluation of VAP Frequency and the Effect of Intranasal Mupirocin in the Development of VAP in a Respiratory Intensive Care Unit
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A5535 - Evaluation of VAP Frequency and the Effect of Intranasal Mupirocin in the Development of VAP in a Respiratory Intensive Care Unit
Author Block: P. Korkmaz Ekren1, Z. N. Toreyin2, B. Uysaler1, S. Aydemir3, H. Pullukcu4, A. Sayiner1, F. Bacakoglu1; 1Chest Disease, Ege University School of Medicine, Izmir, Turkey, 2Public Health, Ege University, Izmir, Turkey, 3Microbiology, Ege University School of Medicine, Izmir, Turkey, 4Infectious Diseases and Clinical Microbiology, Ege University School of Medicine, Izmir, Turkey.
Rationale: Ventilator associated pneumonia (VAP) is a frequent nosocomial infection among respiratory-intensive care unit patients. Intranasal mupirocin administration is recommended in critically ill patients to prevent development of VAP. The objective of the study is to detect frequency of VAP and to evaluate the effect of intranasal mupirocin on the development of VAP due to MRSA.
Methods: The patients in respiratory intensive care unit of Ege University Department of Chest Diseases from 2011 to 2016 were evaluated in this retrospective cohort study. Intranasal mupirocin ointment has been applied since September 2014.
Results: 195 patients (139 male, median age 71, mean APACHE II 23.6 ± 7.9) who had clinical, laboratory and radiological findings consistent with VAP, and microbiological confirmation made by lower respiratory tract sampling included in the study. VAP frequencies within years were 17%, 27%, 22%, 23%, 17% and 15% respectively. The most frequent isolated pathogen was A. baumannii (60%), followed by P. aeruginosa and MRSA (20.1% and 5.6%, respectively). All MRSA VAP were diagnosed before mupirocin ointment application. Among isolated pathogens 12.3% were drug-sensitive, 28.3% were multidrug-resistant (MDR) and 58.5% were extensively drug-resistant (XDR). VAP causing agents and drug-resistance patterns were similar in early-onset and late-onset VAP groups. Lowest and highest annual mortality rates were 71.1% and 87.1%, respectively (p=0.72).
Conclusion: The most frequent isolated pathogen was A. baumannii. Most of the isolated pathogens were multidrug-resistant (MDR) and extensively drug-resistant (XDR). Intranasal mupirocin application was preventive for MRSA VAP.
Author Block: P. Korkmaz Ekren1, Z. N. Toreyin2, B. Uysaler1, S. Aydemir3, H. Pullukcu4, A. Sayiner1, F. Bacakoglu1; 1Chest Disease, Ege University School of Medicine, Izmir, Turkey, 2Public Health, Ege University, Izmir, Turkey, 3Microbiology, Ege University School of Medicine, Izmir, Turkey, 4Infectious Diseases and Clinical Microbiology, Ege University School of Medicine, Izmir, Turkey.
Rationale: Ventilator associated pneumonia (VAP) is a frequent nosocomial infection among respiratory-intensive care unit patients. Intranasal mupirocin administration is recommended in critically ill patients to prevent development of VAP. The objective of the study is to detect frequency of VAP and to evaluate the effect of intranasal mupirocin on the development of VAP due to MRSA.
Methods: The patients in respiratory intensive care unit of Ege University Department of Chest Diseases from 2011 to 2016 were evaluated in this retrospective cohort study. Intranasal mupirocin ointment has been applied since September 2014.
Results: 195 patients (139 male, median age 71, mean APACHE II 23.6 ± 7.9) who had clinical, laboratory and radiological findings consistent with VAP, and microbiological confirmation made by lower respiratory tract sampling included in the study. VAP frequencies within years were 17%, 27%, 22%, 23%, 17% and 15% respectively. The most frequent isolated pathogen was A. baumannii (60%), followed by P. aeruginosa and MRSA (20.1% and 5.6%, respectively). All MRSA VAP were diagnosed before mupirocin ointment application. Among isolated pathogens 12.3% were drug-sensitive, 28.3% were multidrug-resistant (MDR) and 58.5% were extensively drug-resistant (XDR). VAP causing agents and drug-resistance patterns were similar in early-onset and late-onset VAP groups. Lowest and highest annual mortality rates were 71.1% and 87.1%, respectively (p=0.72).
Conclusion: The most frequent isolated pathogen was A. baumannii. Most of the isolated pathogens were multidrug-resistant (MDR) and extensively drug-resistant (XDR). Intranasal mupirocin application was preventive for MRSA VAP.
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