Ventilator-associated pneumonia (VAP) pathogenic microorganisms eradication and persistence during antimicrobial therapy

Introduction: There exist few data about the eradication rate of endotracheal colonization during the therapy for VAP. Aims: We evaluated eradication by ETA cultures in a cohort of patients with microbiologically confirmed VAP. Methods: VAP was diagnosed in those mechanically ventilated patients for ≥ 48 h who developed clinical criteria plus a BAL culture grew ≥ 10 4 colony forming units (cfu) of any pathogenic microorganism. Colonization was studied by bi-weekly endotracheal aspirate (ETA) quantitative cultures. Results: 68 episodes of VAP had performed at least one follow-up ETA culture. The VAP pathogens and those newly acquired during the therapy are displayed in table 1. The rate of eradication and the rate of newly acquired colonization is displayed in figure 1. Pathogens persisted during 6.7 days for P. aeruginosa , 6.5 days Acinetobacter spp, 2.4 days S. aureus and 4.0 days other pathogens. Conclusions: Endotracheal colonization persisted despite appropriate therapy; acquired colonization appeared after the second follow up culture and could precede a recurrent VAP episode.