Study of ventilator-associated tracheobronchitis in respiratory ICU patients and the impact of aerosolized antibiotics on their outcome

Abstract Background Lower respiratory tract infections in intubated patients include ventilator-associated tracheobronchitis (VAT) and ventilator-associated pneumonia. Aerosol delivery to intubated patients has improved with advances in techniques and with the development of newer aerosol generators...

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Main Author: Hanaa Ali
Format: Article
Language:English
Published: SpringerOpen 2016-11-01
Series:The Egyptian Journal of Bronchology
Subjects:
Online Access:http://link.springer.com/article/10.4103/1687-8426.193628
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spelling doaj-a1fb1f51919c40baa8d0526dc3c0b65e2020-11-25T03:13:22ZengSpringerOpenThe Egyptian Journal of Bronchology1687-84262314-85512016-11-0110330130910.4103/1687-8426.193628Study of ventilator-associated tracheobronchitis in respiratory ICU patients and the impact of aerosolized antibiotics on their outcomeHanaa Ali0Chest ICU, Ain Shams University HospitalAbstract Background Lower respiratory tract infections in intubated patients include ventilator-associated tracheobronchitis (VAT) and ventilator-associated pneumonia. Aerosol delivery to intubated patients has improved with advances in techniques and with the development of newer aerosol generators. Aim The aim of the current study was to assess VAT and study the effect of aerosolized antibiotics (AAs) as an adjuvant to systemic antibiotic (SA) on outcome in VAT patients over 18 months, starting from December 2013, who were admitted to the respiratory ICU of Ain Shams University Hospital. Patients and methods Seventy-four patients out of 104 mechanically ventilated patients admitted to the respiratory ICU were subjected to serial mini-BAL sputum sampling from the first day of mechanical ventilation (MV). Thirty-two patients who developed VAT were divided into two groups: group I (13 VAT patients who received AAs in the form of ceftazidime 500 mg/12 h+amikacin 400 mg/12 h added to the SA) and group II (10 VAT patients who received only SA). The current study included only those patients whose relatives agreed to share in the study. All patients were subjected to daily assessment for signs of respiratory tract infection and to twice weekly chest radiography, leukocytic count evaluation, and microbiological assessment using mini-BAL. Results VAT incidence was found to be 22.1%. Eighty percent of patients who received AAs showed clinical improvement in the form of significant decrease in temperature, amount of sputum, and leukocytic count, and significant increase in PaO2/FiO2 ratio, in comparison with 30% in the SA group. Conclusion The incidence of VAT was found to be 22.1%, and was mainly caused by Gram-negative bacteria. AAs adjuvant to SA were effective in rapid resolution of signs of respiratory infection, in causing decreased bacterial load, reduced bacterial resistance, reduced progression of VAT to ventilator-associated pneumonia, reduced days of SA use, decreasedMVdays and ICU stay days, and probably reduced cost of ICU admission, but did not affect mortality.http://link.springer.com/article/10.4103/1687-8426.193628aerosolized antibioticsmini-BALventilator-associated tracheobronchitis
collection DOAJ
language English
format Article
sources DOAJ
author Hanaa Ali
spellingShingle Hanaa Ali
Study of ventilator-associated tracheobronchitis in respiratory ICU patients and the impact of aerosolized antibiotics on their outcome
The Egyptian Journal of Bronchology
aerosolized antibiotics
mini-BAL
ventilator-associated tracheobronchitis
author_facet Hanaa Ali
author_sort Hanaa Ali
title Study of ventilator-associated tracheobronchitis in respiratory ICU patients and the impact of aerosolized antibiotics on their outcome
title_short Study of ventilator-associated tracheobronchitis in respiratory ICU patients and the impact of aerosolized antibiotics on their outcome
title_full Study of ventilator-associated tracheobronchitis in respiratory ICU patients and the impact of aerosolized antibiotics on their outcome
title_fullStr Study of ventilator-associated tracheobronchitis in respiratory ICU patients and the impact of aerosolized antibiotics on their outcome
title_full_unstemmed Study of ventilator-associated tracheobronchitis in respiratory ICU patients and the impact of aerosolized antibiotics on their outcome
title_sort study of ventilator-associated tracheobronchitis in respiratory icu patients and the impact of aerosolized antibiotics on their outcome
publisher SpringerOpen
series The Egyptian Journal of Bronchology
issn 1687-8426
2314-8551
publishDate 2016-11-01
description Abstract Background Lower respiratory tract infections in intubated patients include ventilator-associated tracheobronchitis (VAT) and ventilator-associated pneumonia. Aerosol delivery to intubated patients has improved with advances in techniques and with the development of newer aerosol generators. Aim The aim of the current study was to assess VAT and study the effect of aerosolized antibiotics (AAs) as an adjuvant to systemic antibiotic (SA) on outcome in VAT patients over 18 months, starting from December 2013, who were admitted to the respiratory ICU of Ain Shams University Hospital. Patients and methods Seventy-four patients out of 104 mechanically ventilated patients admitted to the respiratory ICU were subjected to serial mini-BAL sputum sampling from the first day of mechanical ventilation (MV). Thirty-two patients who developed VAT were divided into two groups: group I (13 VAT patients who received AAs in the form of ceftazidime 500 mg/12 h+amikacin 400 mg/12 h added to the SA) and group II (10 VAT patients who received only SA). The current study included only those patients whose relatives agreed to share in the study. All patients were subjected to daily assessment for signs of respiratory tract infection and to twice weekly chest radiography, leukocytic count evaluation, and microbiological assessment using mini-BAL. Results VAT incidence was found to be 22.1%. Eighty percent of patients who received AAs showed clinical improvement in the form of significant decrease in temperature, amount of sputum, and leukocytic count, and significant increase in PaO2/FiO2 ratio, in comparison with 30% in the SA group. Conclusion The incidence of VAT was found to be 22.1%, and was mainly caused by Gram-negative bacteria. AAs adjuvant to SA were effective in rapid resolution of signs of respiratory infection, in causing decreased bacterial load, reduced bacterial resistance, reduced progression of VAT to ventilator-associated pneumonia, reduced days of SA use, decreasedMVdays and ICU stay days, and probably reduced cost of ICU admission, but did not affect mortality.
topic aerosolized antibiotics
mini-BAL
ventilator-associated tracheobronchitis
url http://link.springer.com/article/10.4103/1687-8426.193628
work_keys_str_mv AT hanaaali studyofventilatorassociatedtracheobronchitisinrespiratoryicupatientsandtheimpactofaerosolizedantibioticsontheiroutcome
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