• J Rello, V Ausina, M Ricart, C Puzo, E Quintana, A Net, and G Prats.
• Intensive Care Department, Hospital de Sabadell, Barcelona, Spain.
• Intensive Care Med. 1994 Jan 1;20(3):193-8.

Objectiveto investigate the epidemiology of infection by Pseudomonas aeruginosa in patients with ventilator-associated pneumonia (VAP).Designprospective clinical study.Settinga medical-surgical ICU in a university hospital.Patientswe followed-up 568 mechanically ventilated patients and 83 episodes of VAP with etiologic diagnosis in 72 patients were retained for analysis.ResultsPs. aeruginosa was isolated in 22 (26.5%) episodes in 18 patients. Of these episodes 7 were directly responsible for death. Using logistic regression analysis, the risk of VAP due to Ps. aeruginosa was increased in patients with chronic obstructive pulmonary disease (relative risk (RR) = 29.9, 95% confidence interval (CI) = 4.86-184.53), a mechanical ventilation period longer than 8 days (RR = 8.1, 95% CI = 1.01-65.40) and prior use of antibiotics (RR = 5.5, 95% CI = 0.88-35.01).Conclusionspatients with VAP and these factors have a greater risk of infection by Ps. aeruginosa and empirical therapy for these episodes should include anti-pseudomonal activity until etiologic diagnosis is established.

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