metricas
covid
Buscar en
Enfermedades Infecciosas y Microbiología Clínica
Toda la web
Inicio Enfermedades Infecciosas y Microbiología Clínica Severe, non-bacteremic infections in ICU patients
Información de la revista
Vol. 29. Núm. S4.
Update on infectious diseases
Páginas 1-9 (marzo 2011)
Compartir
Compartir
Descargar PDF
Más opciones de artículo
Vol. 29. Núm. S4.
Update on infectious diseases
Páginas 1-9 (marzo 2011)
Acceso a texto completo
Severe, non-bacteremic infections in ICU patients
Infecciones graves no bacteriémicas en pacientes de cuidados intensivos
Visitas
3149
José M. Aguadoa,
Autor para correspondencia
jaguadog@medynet.com

Correspondence author.
, Antonio Torresb, Patricia Muñozc, Álex Sorianod, Jordi Carrataláe, Xavier Guiraof, Evaristo Varog
a Unidad de Enfermedades Infecciosas, Hospital Universitario 12 de Octubre, Universidad Complutense, Madrid, Spain
b Servei de Pneumologia i Al·lergia Respiratòria, Institut Clínic del Tórax, Hospital Clínic, Universitat de Barcelona, IDIBAPS, CIBERES, Barcelona, Spain
c Servicio de Microbiología Clínica y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, CIBERES, Universidad Complutense, Madrid, Spain
d Servicio de Enfermedades Infecciosas, Hospital Clínic, Barcelona, Spain
e Servicio de Enfermedades Infecciosas, Hospital Universitari de Bellvitge, Institut d’Investigació Biomèdica de Bellvitge (IDIBELL), Universidad de Barcelona, Barcelona, Spain
f Departamento de Cirugía, Hospital Universitari del Mar, Barcelona, Spain
g Unidad de Trasplante Abdominal y Unidad de Cuidados Intensivos, Hospital Universitario de Santiago, Santiago de Compostela, A Coruña, Spain
Este artículo ha recibido
Información del artículo
Abstract

The present article is an update of the literature on various types of infections in ICU patients: ventilator-associated pneumonia, community-acquired pneumonia, the impact of the increasing vancomycin MIC in Staphylococcus aureus in the treatment of infections caused by this microorganism and the usefulness of biomarkers in identifying or ruling out septic complications in ICU patients. A multidisciplinary group of Spanish physicians with an interest in infections in critically-ill patients selected the most important recently published papers produced in the field. One of the members of the group discussed the content of each of the selected papers, with a critical appraisal by other members of the panel.

Keywords:
Intensive care units
Ventilator-associated pneumonia
Severe community acquired-pneumonia
Staphylococcus aureus
Vancomycin
Minimum inhibitory concentration
Biological markers
Resumen

El artículo presente recoge una actualización bibliográfica de varios tipos de infecciones en pacientes de cuidados intensivos: la neumonía asociada a ventilación mecánica, la neumonía adquirida en la comunidad, la repercusión del incremento de la CMI a vancomicina en el tratamiento de las infecciones causadas por Staphylococcus aureus y la utilidad de los biomarcadores en el diagnóstico de las complicaciones infecciosas en estos pacientes. Un grupo multidisciplinario de clínicos españoles con experiencia en las infecciones en enfermos críticos seleccionó las publicaciones más importantes en este campo aparecidas recientemente. El contenido de cada uno de los artículos seleccionados fue expuesto y discutido por uno de los miembros del grupo, después de lo cual los miembros restantes efectuaron una revisión crítica.

Palabras clave:
Unidad de cuidados intensivos
Neumonía asociada a ventilación mecánica
Neumonía comunitaria grave
Staphylococcus aureus
Vancomicina
Concentración mínima inhibitoria
Marcadores biológicos
El Texto completo está disponible en PDF
References
[1.]
D.K. Heyland, D.J. Cook, L. Griffith, S.P. Keenan, C. Brun-Buisson.
The attributable morbidity and mortality of ventilator-associated pneumonia in the critically ill patient. The Canadian Critical Trials Group.
Am J Respir Crit Care Med, 159 (1999), pp. 1249-1256
[2.]
Guidelines for the management of adults with hospital-acquired.
ventilator-associated, and healthcare-associated pneumonia.
Am J Respir Crit Care Med, 171 (2005), pp. 388-416
[3.]
J.M. Sánchez-Nieto, A. Torres, F. García-Córdoba, M. El-Ebiary, A. Carrillo, J. Ruiz, et al.
Impact of invasive and noninvasive quantitative culture sampling on outcome of ventilator-associated pneumonia: a pilot study.
Am J Respir Crit Care Med., 157 (1998), pp. 371-376
[4.]
M. Ruiz, A. Torres, S. Ewig, M.A. Marcos, A. Alcón, R. Lledó, et al.
Noninvasive versus invasive microbial investigation in ventilator-associated pneumonia: evaluation of outcome.
Am J Respir Crit Care Med, 162 (2000), pp. 119-125
[5.]
J. Solé Violán, J.A. Fernández, A.B. Benítez, J.A. Cardenosa Cendrero, F. Rodríguez de Castro.
Impact of quantitative invasive diagnostic techniques in the management and outcome of mechanically ventilated patients with suspected pneumonia.
Crit Care Med, 28 (2000), pp. 2737-2741
[6.]
J.Y. Fagon, J. Chastre, M. Wolff, C. Gervais, S. Parer-Aubas, F. Stephan, et al.
Invasive and noninvasive strategies for management of suspected ventilator-associated pneumonia. A randomized trial.
Ann Intern Med, 132 (2000), pp. 621-630
[7.]
J. Chastre.
Conference summary: ventilator-associated pneumonia.
Respir Care., 50 (2005), pp. 975-983
[8.]
M.H. Kollef, S. Ward.
The influence of mini-BAL cultures on patient outcomes: implications for the antibiotic management of ventilator-associated pneumonia.
Chest, 113 (1998), pp. 412-420
[9.]
F. Álvarez-Lerma.
Modification of empiric antibiotic treatment in patients with pneumonia acquired in the intensive care unit ICU-Acquired Pneumonia Study Group.
Intensive Care Med, 22 (1996), pp. 387-394
[10.]
E. Bouza, M.V. Torres, C. Radice, E. Cercenado, R. De Diego, C. Sánchez-Carrillo, et al.
Direct E-test (AB Biodisk) of respiratory samples improves antimicrobial use in ventilator-associated pneumonia.
Clin Infect Dis, 44 (2007), pp. 382-387
[11.]
J. Garnacho-Montero, M. Sa-Borges, J. Solé-Violán, F. Barcenilla, A. Escoresca-Ortega, M. Ochoa, et al.
Optimal management therapy for Pseudomonas aeruginosa ventilator-associated pneumonia: an observational, multicenter study comparing monotherapy with combination antibiotic therapy.
Crit Care Med, 35 (2007), pp. 1888-1895
[12.]
The Canadian Critical Care Trials Group.
A randomized trial of diagnostic techniques for ventilator-associated pneumonia.
N Engl J Med, 355 (2006), pp. 2619-2630
[13.]
M.H. Kollef.
Diagnosis of ventilator-associated pneumonia.
N Engl J Med., 355 (2006), pp. 2691-2693
[14.]
M.H. Kollef, B. Afessa, A. Anzueto, C. Veremakis, K.M. Kerr, B.D. Margolis, et al.
Silver-coated endotracheal tubes and incidence of ventilator-associated pneumonia: the NASCENT randomized trial.
JAMA, 300 (2008), pp. 805-813
[15.]
J. Rello, B. Afessa, A. Anzueto, A.C. Arroliga, M.E. Olson, M.I. Restrepo, et al.
Activity of a silver-coated endotracheal tube in preclinical models of ventilator-associated pneumonia and a study after extubation.
Crit Care Med, 38 (2010), pp. 1135-1140
[16.]
D.J. Nazarian, O.L. Eddy, T.W. Lukens, S.D. Weingart, W.W. Decker.
Clinical policy: critical issues in the management of adult patients presenting to the emergency department with community-acquired pneumonia.
Ann Emerg Med, 54 (2009), pp. 704-731
[17.]
A. Rodríguez, A. Mendia, J.M. Sirvent, F. Barcenilla, M.V. De la Torre-Prados, J. Solé-Violán, et al.
Combination antibiotic therapy improves survival in patients with community-acquired pneumonia and shock.
Crit Care Med, 35 (2007), pp. 1493-1498
[18.]
G.W. Waterer.
Monotherapy versus combination antimicrobial therapy for pneumococcal pneumonia.
Curr Opin Infect Dis, 18 (2005), pp. 157-163
[19.]
L.M. Baddour, V.L. Yu, K.P. Klugman, C. Feldman, A. Ortqvist, J. Rello, et al.
Combination antibiotic therapy lowers mortality among severely ill patients with pneumococcal bacteremia.
Am J Respir Crit Care Med, 170 (2004), pp. 440-444
[20.]
I. Martín-Loeches, T. Lisboa, A. Rodríguez, C. Putensen, D. Annane, J. Garnacho-Montero, et al.
Combination antibiotic therapy with macrolides improves survival in intubated patients with community-acquired pneumonia.
Intensive Care Med, 36 (2010), pp. 612-620
[21.]
D.K. Heyland, P. Dodek, J. Muscedere, A. Day, D. Cook.
Randomized trial of combination versus monotherapy for the empiric treatment of suspected ventilator-associated pneumonia.
Crit Care Med, 36 (2008), pp. 737-744
[22.]
B. Renaud, A. Santín, E. Coma, N. Camus, D. Van Pelt, J. Hayon, et al.
Association between timing of intensive care unit admission and outcomes for emergency department patients with community-acquired pneumonia.
Crit Care Med, 37 (2009), pp. 2867-2874
[23.]
C. McCabe, C. Kirchner, H. Zhang, J. Daley, D.N. Fisman.
Guideline-concordant therapy and reduced mortality and length of stay in adults with community-acquired pneumonia: playing by the rules.
Arch Intern Med, 169 (2009), pp. 1525-1531
[24.]
F.W. Arnold, A.S. LaJoie, G.N. Brock, P. Peyrani, J. Rello, R. Menéndez, et al.
Improving outcomes in elderly patients with community-acquired pneumonia by adhering to national guidelines: Community-Acquired Pneumonia Organization International cohort study results.
Arch Intern Med, 169 (2009), pp. 1515-1524
[25.]
M. Venditti, M. Falcone, S. Corrao, G. Licata, P. Serra.
Outcomes of patients hospitalized with community-acquired, health care-associated, and hospital-acquired pneumonia.
Ann Intern Med, 150 (2009), pp. 19-26
[26.]
T. Lisboa, S. Blot, G.W. Waterer, E. Canalis, D. De Mendoza, A. Rodríguez, et al.
Radiologic progression of pulmonary infiltrates predicts a worse prognosis in severe community-acquired pneumonia than bacteremia.
Chest, 135 (2009), pp. 165-172
[27.]
J. Bordon, P. Peyrani, G.N. Brock, F. Blasi, J. Rello, T. File, et al.
The presence of pneumococcal bacteremia does not influence clinical outcomes in patients with community-acquired pneumonia: results from the Community-Acquired Pneumonia Organization (CAPO) International Cohort study.
Chest, 133 (2008), pp. 618-624
[28.]
B.P. Howden, P.B. Ward, P.G. Charles, T.M. Korman, A. Fuller, P. Du Cros, et al.
Treatment outcomes for serious infections caused by methicillin-resistant Staphylococcus aureus with reduced vancomycin susceptibility.
Clin Infect Dis, 38 (2004), pp. 521-528
[29.]
L.K. Hidayat, D.I. Hsu, R. Quist, K.A. Shriner, A. Wong-Beringer.
High-dose vancomycin therapy for methicillin-resistant Staphylococcus aureus infections: efficacy and toxicity.
Arch Intern Med, 166 (2006), pp. 2138-2144
[30.]
A. Soriano, F. Marco, J.A. Martínez, E. Pisos, M. Almela, V.P. Dimova, et al.
Influence of vancomycin minimum inhibitory concentration on the treatment of methicillin-resistant Staphylococcus aureus bacteremia.
Clin Infect Dis, 46 (2008), pp. 193-200
[31.]
S.K. Pillai, C. Wennersten, L. Venkataraman, G.M. Eliopoulos, R.C. Moellering, A.W. Karchmer.
Development of reduced vancomycin susceptibility in methicillin-susceptible Staphylococcus aureus.
Clin Infect Dis, 49 (2009), pp. 1169-1174
[32.]
M.W. Climo, K.A. Sepkowitz, G. Zuccotti, V.J. Fraser, D.K. Warren, T.M. Perl, et al.
The effect of daily bathing with chlorhexidine on the acquisition of methicillin-resistant Staphylococcus aureus, vancomycin-resistant Enterococcus, and healthcare-associated bloodstream infections: results of a quasi-experimental multicenter trial.
Crit Care Med, 37 (2009), pp. 1858-1865
[33.]
R.S. Chamberlain, D.L. Culshaw, B.J. Donovan, K.C. Lamp.
Daptomycin for the treatment of surgical site infections.
Surgery, 146 (2009), pp. 316-324
[34.]
H.C. Jang, S.H. Kim, K.H. Kim, C.J. Kim, S. Lee, K.H. Song, et al.
Salvage treatment for persistent methicillin-resistant Staphylococcus aureus bacteremia: efficacy of linezolid with or without carbapenem.
Clin Infect Dis, 49 (2009), pp. 395-401
[35.]
B.M. Rau, I. Frigerio, M.W. Buchler, K. Wegscheider, C. Bassi, P.A. Puolakkainen, et al.
Evaluation of procalcitonin for predicting septic multiorgan failure and overall prognosis in secondary peritonitis: a prospective, international multicenter study.
Arch Surg, 142 (2007), pp. 134-142
[36.]
J. Schroder, K.H. Staubach, P. Zabel, F. Stuber, B. Kremer.
Procalcitonin as a marker of severity in septic shock.
Langenbecks Arch Surg, 384 (1999), pp. 33-38
[37.]
H.B. Reith, U. Mittelkotter, R. Wagner, A. Thiede.
Procalcitonin (PCT) in patients with abdominal sepsis.
Intensive Care Med, 26 Suppl 2 (2000), pp. S165-S169
[38.]
J.C. Marshall, J.L. Vincent, M.P. Fink.
Measures, markers and mediators: toward a staging system for clinical sepsis: a report of the fifth Noronto Sepsis Roundtable.
Crit Care Med, 31 (2003), pp. 1560-1567
[39.]
M. Assicot, D. Gendrel, H. Carsin, J. Raymond, J. Guilbaud, C. Bohuon.
High serum procalcitonin concentrations in patients with sepsis and infection.
Lancet, 341 (1993), pp. 515-518
[40.]
L. Simon, F. Gauvin, D.K. Amre, P. Saint-Louis, J. Lacroix.
Serum procalcitonin and C-reactive protein levels as markers of bacterial infection: a systematic review and meta-analysis.
Clin Infect Dis, 39 (2004), pp. 206-217
Copyright © 2011. Elsevier España S.L.. All rights reserved
Descargar PDF
Opciones de artículo
es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos