gms | German Medical Science

57. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

11. bis 14.05.2006, Essen

Bacterial airway colonizations and nosocomial pneumonia in a single neurosurgical intensive care unit

Bakterielle Atemwegskolonisationen und nosokomiale Pneumonien in einer neurochirurgischen Intensivstation

Meeting Abstract

  • corresponding author T. Kral - Department of Neurosurgery, University of Bonn
  • A. Aliashkevich - Department of Neurosurgery, Wellington Hospital, New Zealand
  • E. Hoffmann - Department of Neurosurgery, University of Bonn
  • G. Marklein - Institute for Medical Microbiology and Immunology, University of Bonn
  • C. Schaller - Department of Neurosurgery, University of Bonn

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 57. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie. Essen, 11.-14.05.2006. Düsseldorf, Köln: German Medical Science; 2006. DocP 02.23

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2006/06dgnc240.shtml

Veröffentlicht: 8. Mai 2006

© 2006 Kral et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective: In order to enhance current knowledge of nosocomial bacterial pneumonia in a single neurosurgical intensive care unit, a prospective study was conducted.

Methods: We evaluated upper and lower airway colonization patterns with or without the development of early (day 0 – 4 of ICU stay) or late (> day 4 of ICU stay) pneumonia in 113 patients. The incidence rates of microorganisms identified in upper and/or lower airway according to the types of pneumonia were studied. Swabs were taken twice a week with follow-up until discharge.

Results: Compared to 52 patients without pneumonia (group I), 45 patients developed an early onset (group II) and 16 patients a late onset (group III) pneumonia. A significant (p<0.01) longer ICU-stay (group I: 11.0 days; group II: 16.2 days; group III: 19.6 days) and a prolonged ventilation (group I: 7.2 days; group II: 12.0 days; group III: 15.0 days) were associated with pneumonia. The most important colonizations in the upper and and lower airways were Enterobakteriaceae (group B), Enterococci/non-hemolytic Streptococci (group D), Staphylococcus aureus (group G), coagulase-negative Staphylococci/Corynebacteria (group H) and Candida types (group L). The colonization rates of the upper airways were 27% - 54% in group I patients (no pneumonia), 22% - 69% in group II patients and 50% - 88% in group III patients. A significant difference of colonization rates with microorganisms of groups D, G and H was found in the lower airways with colonization rates of 21% - 29% in patients without pneumonia versus 44% - 56% in patients with late onset pneumonia.

Conclusions: Nosocomial early and late onset pneumonia were associated with duration of ICU stay and long-term ventilation. The upper airways seem to represent an important reservoir for lower airway colonization and nosocomial pneumonia in neurosurgical ICU patients.