The microbiology of ventilator-associated pneumonia.

摘要: Ventilator-associated pneumonia (VAP) is a common complication of ventilatory support for patients with acute respiratory failure and associated increased morbidity, mortality, costs. Awareness the microbiology VAP essential selecting optimal antibiotic therapy improving these outcomes. The specific microbial causes are many varied. Most cases caused by bacterial pathogens that normally colonize oropharynx gut, or acquired via transmission health-care workers from environmental surfaces other patients. Common include Pseudomonas species highly resistant Gram-negative bacilli, staphylococci, Enterobacteriaceae, streptococci, Haemophilus species. Antibiotic-resistant such as Acinetobacter methicillin-resistant strains Staphylococcus aureus much more after prior treatment prolonged hospitalization mechanical ventiation, when risk factors present. responsible also vary depending on patient characteristics in certain clinical circumstances, distress syndrome following tracheostomy, traumatic injuries, burns. But differences appear to be due primarily duration ventilation and/or degree exposure can considerably geographic location (even between units same hospital), emphasizing importance local epidemiological microbiological data. Atypical bacteria, viruses, fungi have been implicated VAP, but not studied systematically their role presently unclear. In conclusion, information about serves guide therapy. antibiotic-resistant estimated using simple features awareness patterns. roles atypical nonbacterial incompletely understood should investigated further.