Improved outcome of ventilator-associated pneumonia caused by methicillin-resistant Staphylococcus aureus in a trauma population

Am J Surg. 2013 Mar;205(3):255-8; discussion 258. doi: 10.1016/j.amjsurg.2012.10.011. Epub 2013 Jan 30.

Abstract

Background: The treatment of ventilator-associated pneumonia (VAP) secondary to methicillin-resistant Staphylococcus aureus (MRSA) remains controversial.

Methods: We performed a review of all blunt trauma patients diagnosed with MRSA VAP from June 2005 to June 2011. VAP for the first 3 years was diagnosed by sputum aspiration and treated with vancomycin. For the last 3 years of the study period, VAP was diagnosed with bronchoalveolar lavage and treated with linezolid.

Results: MRSA VAP patients treated with vancomycin had an average hospital length of stay (LOS) of 49 days (range 9-99 days), an average intensive care unit (ICU) LOS of 43 days (range 6-98 days), and average ventilator days of 34.4 (range 3-76 days). Seventeen MRSA VAP patients treated with linezolid had an average hospital LOS of 27 days (range 11-61), an average ICU LOS of 22 days (range 10-42) days, and average ventilator days of 16.6 (range 2-42).

Conclusions: Trauma patients who develop MRSA VAP appear to have fewer ventilator days and shorter ICU and hospital LOS when treated with linezolid.

MeSH terms

  • Acetamides / therapeutic use
  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / therapeutic use
  • Anti-Infective Agents / therapeutic use
  • Bronchoalveolar Lavage
  • Female
  • Humans
  • Intensive Care Units / statistics & numerical data
  • Length of Stay / statistics & numerical data
  • Linezolid
  • Male
  • Methicillin-Resistant Staphylococcus aureus*
  • Middle Aged
  • Oxazolidinones / therapeutic use
  • Pneumonia, Staphylococcal / diagnosis
  • Pneumonia, Staphylococcal / drug therapy
  • Pneumonia, Staphylococcal / microbiology*
  • Pneumonia, Staphylococcal / mortality
  • Pneumonia, Ventilator-Associated / diagnosis
  • Pneumonia, Ventilator-Associated / drug therapy
  • Pneumonia, Ventilator-Associated / microbiology*
  • Pneumonia, Ventilator-Associated / mortality
  • Retrospective Studies
  • Treatment Outcome
  • Vancomycin / therapeutic use
  • Wounds, Nonpenetrating / complications*
  • Wounds, Nonpenetrating / mortality

Substances

  • Acetamides
  • Anti-Bacterial Agents
  • Anti-Infective Agents
  • Oxazolidinones
  • Vancomycin
  • Linezolid