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Korean J Crit Care Med > Volume 22(1); 2007 > Article
Korean Journal of Critical Care Medicine 2007;22(1): 1-6.
Methicillin 내성 Staphylococcus aureus (MRSA)가 배양된 병원 내 폐렴 환자에서 Vancomycin 조기 투여의 효과
서용우*ㆍ이정은*ㆍ민보람*ㆍ박재석*ㆍ김정은*ㆍ장영윤*ㆍ박훈표*ㆍ류남희†ㆍ최원일*
계명대학교 의과대학 *내과학교실, †진단검사의학교실
Clinical Outcomes of Early Vancomycin Administration before Identification of Methicillin-resistant Staphylococcus aureus in Patients with Nosocomial Pneumonia
Yong Woo Seo, Jung Eun Lee, Bo Ram Min, Jae Seok Park, Jeong Eun Kim, Young Yun Jang, Hun Pyo Park, Nam Hee Ryoo, Won Il Choi
1Department of Medicine, Keimyung University School of Medicine, Daegu, Korea. wichoi@dsmc.or.kr
2Department of Laboratory Medicine, Keimyung University School of Medicine, Daegu, Korea.
ABSTRACT
BACKGROUND: The aim of this study is to determine the clinical outcomes of early vancomycin administration before identification of methicillin-resistant Staphylococcus aureus (MRSA) in patients with nosocomial pneumonia on a ventilator. METHODS: We retrospectively reviewed patients with nosocomial pneumonia in a 20-bed medical ICU during a period of 2 years and 2 months. This study included 52 inpatients, who were admitted for more than 72 hr and had a new or progressive lung infiltrate plus at least two of the following three criteria for pneumonia: abnormal body temperature (>38oC or <35oC), abnormal leukocyte count (>10,000/mm3 or <3,000/mm3), and purulent bronchial secretions. All of the MRSA were identified in tracheal aspirates during mechanical ventilation. RESULTS: A total of 23 patients who received vancomycin prior to identification of MRSA exhibited a 28-day mortality rate of 60%, while 29 patients who received vancomycin after identification of MRSA showed a 28-day mortality rate of 40% (p=0.17). There was no statistically significant difference in severity index and routine laboratory findings between the two groups. CONCLUSIONS: Early vancomycin administration before identification of MRSA does not appear to affect the mortality rate for patients with nosocomial pneumonia.
Key Words: Methicillin-resistant Staphylocoreccus aureus; Nosocomial pneumonia; Tracheal aspiration; Vancomycin
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