Please use this identifier to cite or link to this item: http://hdl.handle.net/11054/33
Title: Inapparent outbreaks of ventilator-associated pneumonia: an ecologic analysis of prevention and cohort studies.
Authors: Hurley, James C.
Issue Date: 2005
Publisher: University of Chicago Press
Place of publication: Chicago
Journal title: Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America
Volume: 26
Issue: 4
Start Page: 374
End Page: 390
Abstract: OBJECTIVE: To compare ventilator-associated pneumonia (VAP) rates and patterns of isolates across studies of antibiotic and non-antibiotic methods for preventing VAP. DESIGN: With the use of 42 cohort study groups as the reference standard, the prevalence of VAP was modeled in two linear regressions: one with the control groups and the other with the intervention groups of 96 VAP prevention studies. The proportion of patients admitted with trauma and the VAP diagnostic criteria were used as ecologic correlates. Also, the patterns of pathogenic isolates were available for 117 groups. RESULTS: In the first regression model, the VAP rates for the control groups of antibiotic-based prevention studies were at least 18 (CI95, 12 to 24) per 100 patients higher than those in the cohort study groups (P < .001). By contrast, comparisons of cohort study groups with all other control and intervention groups in the first and second regression models yielded differences that were less than 6 per 100 and not significant (P > .05). For control groups with VAP rates greater than 35%, the patterns of VAP isolates, such as the proportion of Staphylococcus aureus, more closely resembled those in the corresponding intervention groups than in the cohort groups. CONCLUSIONS: The rates of VAP in the control groups of the antibiotic prevention studies were significantly higher than expected and the patterns of pathogenic isolates were unusual. These observations suggest that inapparent outbreaks of VAP occurred in these studies. The possibility remains that antibiotic-based VAP prevention presents a major cross-infection hazard.
URI: http://hdl.handle.net/11054/33
metadata.dc.relation.uri: http://www.jstor.org/stable/10.1086/502555
ISSN: 0899-823X
Internal ID Number: 00020
Health Subject: ANTI-BACTERIAL AGENTS - THERAPEUTIC USE
CASE CONTROL STUDIES
DISEASE OUTBREAKS - PREVENTION AND CONTROL
ENVIRONMENTAL MONITORING
PNEUMONIA - EPIDEMIOLOGY
PNEUMONIA - ETIOLOGY
PNEUMONIA - PREVENTION AND CONTROL
PSEUDOMONAS AERUGINOSA - ISOLATION AND PURIFICATION
PSEUDOMONAS AERUGINOSA - PATHOGENICITY
RESPIRATION - ARTIFICIAL - ADVERSE EFFECTS
STAPHYLOCOCCUS AUREUS - ISOLATION AND PURIFICATION
STAPHYLOCOCCUS AUREUS - PATHOGENICITY
ANTI-BACTERIAL AGENTS
Type: Journal Article
Article
Appears in Collections:Research Output

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