Treatment of Achromobacter Ventilator-Associated Pneumonia in Critically Ill Trauma Patients

G Christopher Wood, Brittany L. Jonap, George O. Maish, Louis J. Magnotti, Joseph Swanson, Bradley Boucher, Martin Croce, Timothy Fabian

Research output: Contribution to journalArticle

Abstract

Background: Achromobacter sp are nonfermenting Gram-negative bacilli (NFGNB) that rarely cause severe infections, including ventilator-associated pneumonia (VAP). Data on the treatment of Achromobacter pneumonia are very limited, and the organism has been associated with a high mortality rate. Thus, more data are needed on treating this organism. Objective: To evaluate the treatment of Achromobacter VAP in critically ill trauma patients. Methods: This retrospective, observational study evaluated critically ill trauma patients who developed Achromobacter VAP. A previously published pathway for the diagnosis and management of VAP was used according to routine patient care. This included the use of quantitative bronchoscopic bronchoalveolar lavage cultures to definitively diagnose VAP. Results: A total of 37 episodes of Achromobacter VAP occurred in 34 trauma intensive care unit patients over a 15-year period. The most commonly used definitive antibiotics were imipenem/cilastatin, cefepime, or trimethoprim/sulfamethoxazole. The primary outcome of clinical success was achieved in 32 of 37 episodes (87%). This is similar to previous studies of other NFGNB VAP (eg, Pseudomonas, Acinetobacter) from the study center. Microbiological success was seen in 21 of 28 episodes (75%), and VAP-related mortality was 9% (3 of 34 patients). Conclusions: Achromobacter is a rare but potentially serious cause of VAP in critically ill patients. In this study, there was an acceptable success rate compared with other causes of NFGNB VAP in this patient population.

Original languageEnglish (US)
Pages (from-to)120-125
Number of pages6
JournalAnnals of Pharmacotherapy
Volume52
Issue number2
DOIs
StatePublished - Feb 1 2018

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Achromobacter
Ventilator-Associated Pneumonia
Critical Illness
Wounds and Injuries
Bacillus
Therapeutics
Acinetobacter
Mortality
Sulfamethoxazole Drug Combination Trimethoprim
Bronchoalveolar Lavage
Pseudomonas
Observational Studies
Intensive Care Units
Pneumonia
Patient Care
Retrospective Studies

All Science Journal Classification (ASJC) codes

  • Pharmacology (medical)

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Treatment of Achromobacter Ventilator-Associated Pneumonia in Critically Ill Trauma Patients. / Wood, G Christopher; Jonap, Brittany L.; Maish, George O.; Magnotti, Louis J.; Swanson, Joseph; Boucher, Bradley; Croce, Martin; Fabian, Timothy.

In: Annals of Pharmacotherapy, Vol. 52, No. 2, 01.02.2018, p. 120-125.

Research output: Contribution to journalArticle

Wood, G Christopher ; Jonap, Brittany L. ; Maish, George O. ; Magnotti, Louis J. ; Swanson, Joseph ; Boucher, Bradley ; Croce, Martin ; Fabian, Timothy. / Treatment of Achromobacter Ventilator-Associated Pneumonia in Critically Ill Trauma Patients. In: Annals of Pharmacotherapy. 2018 ; Vol. 52, No. 2. pp. 120-125.
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