Prevention of hospital-associated pneumonia and ventilator-associated pneumonia

Critical Care Medicine

Volumn 32, Issue 6, 2004, Pages 1396-1405

  Kollef, Marin H ^a  

^a WASHINGTON UNIVERSITY SCHOOL OF MEDICINE   (United States)

Author keywords

Hospital acquired pneumonia; Intensive care unit; Nosocomial infection; Pneumonia; Ventilator associated pneumonia

Indexed keywords

ANTACID AGENT; ANTIBIOTIC AGENT; ANTIHISTAMINIC AGENT; ANTIINFECTIVE AGENT; VACCINE;

ACINETOBACTER; ASPIRATION PNEUMONIA; BACTERIAL COLONIZATION; BIOFILM; BLOOD TRANSFUSION; DATA BASE; DECOLORIZATION; DISEASE PREDISPOSITION; DRUG EFFICACY; ENDOTRACHEAL INTUBATION; ENTEROBACTER; ERYTHROCYTE; HOSPITAL INFECTION; HUMAN; KLEBSIELLA PNEUMONIAE; MEDLINE; PATHOGENESIS; PNEUMONIA; POSITIVE END EXPIRATORY PRESSURE; PRIORITY JOURNAL; PSEUDOMONAS AERUGINOSA; REVIEW; RISK FACTOR; STAPHYLOCOCCUS AUREUS; STRESS ULCER; SUCTION DRAINAGE; VENTILATOR;

CROSS INFECTION; EQUIPMENT CONTAMINATION; HUMANS; PNEUMONIA; VENTILATORS, MECHANICAL;

EID: 2942620212     PISSN: 00903493     EISSN: None     Source Type: Journal    
DOI: 10.1097/01.CCM.0000128569.09113.FB     Document Type: Review

References (138)

1. McEachern R, Campbell GD Jr: Hospital-acquired pneumonia: Epidemiology, and treatment. Infect Dis Clin North Am 1998; 12:761-779
2. Richards MJ, Edwards JR, Culver DH, et al: Nosocomial infections in medical intensive care units in the United States. Crit Care Med 1999; 27:887-892
3. Gross PA, Neu HC, Aswapokee P, et al: Deaths from nosocomial infections: experience in a university hospital and a community hospital. Am J Med 1980; 68:219-223
4. Fagon J-Y, Chastre J, Domart Y, et al: Nosocomial pneumonia in patients receiving continuous mechanical ventilation: Prospective analysis of 52 episodes with use of a protected specimen brush and quantitative culture techniques. Am Rev Respir Dis 1989; 139:877-884
5. Joshi N, Localio AR, Hamory BH: A predictive risk index for nosocomial pneumonia in the intensive care unit. Am J Med 1992; 93:135-142
6. George DL: Epidemiology of nosocomial pneumonia in intensive care unit patients. Clin Chest Med 1995; 16:29-44
7. Celis R, Torres A, Gatell JM, et al: Nosocomial pneumonia. A multivariate analysis of risk and prognosis. Chest 1988; 93:318-324
8. Fagon J-Y, Chastre J, Hance AJ, et al: Nosocomial pneumonia in ventilated patients: A cohort study evaluating attributable mortality and hospital stay. Am J Med 1993; 94:281-288
9. Bryan CS, Reynolds KL: Bacteremic nosocomial pneumonia: Analysis of 172 episodes from a single metropolitan area. Am Rev Respir Dis 1984; 129:668-671
10. Boyce JM, Potter-Bynoe G, Dziobek L, et al: Nosocomial pneumonia in Medicare patients. Hospital costs and reimbursement patterns under the prospective payment system. Arch Intern Med 1991; 151:1109-1114
11. Rello J, Ollendorf DA, Oster G, et al: Epidemiology and outcomes of ventilator-associated pneumonia in a large US database. Chest 2002; 122:2115-2121
12. Warren DK, Shukla SJ, Olsen MA, et al: Outcomes and attributable cost of ventilator associated pneumonia among intensive care unit patients in a suburban medical center. Crit Care Med 2003; 31:1312-1317
13. Haley RW, White JW, Culver DH, et al: The financial incentive for hospitals to prevent nosocomial infections under the prospective payment system: An empirical determination from a nationally representative sample. JAMA 1987; 257:1611-1614
14. Kollef MH: Epidemiology and risk factors for nosocomial pneumonia. Emphasis on prevention. Clin Chest Med 1999; 20:653-670
15. Kollef MH: The prevention of ventilator-associated pneumonia. N Engl J Med 1999; 340:627-634
16. Zack JE, Garrison T, Trovillion E, et al: Effect of an education program aimed at reducing the occurrence of ventilator-associated pneumonia. Crit Care Med 2002; 30:2407-2412
17. Cook DJ, Kollef MH: Risk factors for ICU-acquired pneumonia. JAMA 1998; 279:1605-1606
18. Arozullah AM, Khuri SF, Henderson WG, et al: Development and validation of a multi-factorial risk index for predicting postoperative pneumonia after major noncardiac surgery. Ann Intern Med 2001; 135:847-857
19. Johanson WG, Pierce AK, Sanford JP, et al: Nosocomial respiratory infections with Gram-negative bacilli. The significance of colonization of the respiratory tract. Ann Intern Med 1972; 77:701-706
20. Johanson WG, Pierce AK, Sanford JP: Changing pharyngeal bacterial flora of hospitalized patients. Emergence of Gram-negative bacilli. N Engl J Med 1969; 281:1137-1140
21. Niederman MS: Bacterial adherence as a mechanism of airway colonization. Eur J Clin Microbiol Infect Dis 1989; 8:15-20
22. Menzies BE: The role of fibronectin binding proteins in the pathogenesis of Staphylococcus aureus infections. Curr Opin Infect Dis 2003; 16:225-229
23. Niederman MS, Merrill WW, Ferranti RD, et al: Nutritional status and bacterial binding in the lower respiratory tract in patients with chronic tracheostomy. Ann Intern Med 1984; 100:795-800
24. Prince AS: Biofilms, antimicrobial resistance, and airway infection. N Engl J Med 2002; 347:1110-1101
25. Craven DE, Steger KA, Barber TW: Preventing nosocomial pneumonia; state of the art and perspectives for the 1990s. Am J Med 1991; 91:44s-53s
26. Bonten MJ, Gaillard CA, de Leeuw PW, et al: Role of colonization of the upper intestinal tract in the pathogenesis of ventilator-associated pneumonia. Clin Infect Dis 1997; 24:309-319
27. van Nieuwenhoven CA, Buskens E, van Tiel FH, et al: Relationship between methodological trial quality and the effects of selective digestive decontamination on pneumonia and mortality in critically ill patients. JAMA 2001; 286:335-340
28. Chastre J, Fagon JY: Ventilator-associated pneumonia. Am J Respir Crit Care Med 2002; 165:867-903
29. Ramsey AH, Skonieczny P, Coolidge DT, et al: Burkholderia cepacia lower respiratory tract infection associated with exposure to a respiratory therapist. Infect Control Hosp Epidemiol 2001; 22:423-426
30. Vassal S, Taamma R, Marty N, et al: Microbiologic contamination study of nebulizers after aerosol therapy in patients with cystic fibrosis. Am J Infect Control 2000; 28:347-351
31. George DL, Falk PS, Wunderink RG, et al: Epidemiology of ventilator-acquired pneumonia based on protected bronchoscopic sampling. Am J Respir Crit Care Med 1998; 158:1839-1847
32. NNIS System. National Nosocomial Infections Surveillance (NNIS) System report, data summary from January 1990-May 1999, issued June 1999. Am J Infect Control 1999; 27:520-532
33. Neuhauser MM, Weinstein RA, Rydman R, et al: Antibiotic resistance among Gram-negative bacilli in US intensive care units: Implications for fluoroquinolone use. JAMA 2003; 289:885-888
34. Dore P, Robert R, Grollier G, et al: Incidence of anaerobes in ventilator-associated pneumonia with use of a protected specimen brush. Am J Respir Crit Care Med 1996; 153:1292-1298
35. Marik PE, Careau P: The role of anaerobes in patients with ventilator-associated pneumonia and aspiration pneumonia: A prospective study. Chest 1999; 115:178-183
36. Collard HR, Saint S, Matthay MA: Prevention of ventilator-associated pneumonia: An evidence-based systematic review. Ann Intern Med 2003; 138:494-501
37. Girou E, Schortgen F, Delclaux C, et al: Association of noninvasive ventilation with nosocomial infections and survival in critically ill patients. JAMA 2000; 284:2361-2367
38. Antonelli M, Conti G, Rocco M, et al: A comparison of noninvasive positive-pressure ventilation and conventional mechanical ventilation in patients with acute respiratory failure. N Engl J Med 1998; 339:429-435
39. Nava S, Ambrosino N, Clini E, et al: Noninvasive mechanical ventilation in the weaning of patients with respiratory failure due to chronic obstructive pulmonary disease. A randomized, controlled trial. Ann Intern Med 1998; 128:721-728
40. Hilbert G, Gruson D, Vargas F, et al: Noninvasive ventilation in immunosuppressed patients with pulmonary infiltrates, fever, and acute respiratory failure. N Engl J Med 2001; 344:481-487
41. Antonelli M, Conti G: Noninvasive positive pressure ventilation as treatment for acute respiratory failure in critically ill patients. Crit Care 2000; 4:15-22
42. Girou E, Brun-Buisson C, Taille S, et al: Secular trends in nosocomial infections and mortality associated with noninvasive ventilation in patients with exacerbations of COPD and pulmonary edema. JAMA 2003; 290:2985-2991
43. Ibrahim EH, Tracy L, Hill C, et al: The occurrence of ventilator-associated pneumonia in a community hospital: Risk factors and clinical outcomes. Chest 2001; 120:555-561
44. Cook DJ, Walter SD, Cook RJ, et al: Incidence of and risk factors for ventilator-associated pneumonia in critically ill patients. Ann Intern Med 1998; 129:433-440
45. Brook AD, Ahrens TS, Schaiff R, et al: Effect of a nursing-implemented sedation protocol on the duration of mechanical ventilation. Crit Care Med 1999; 27:2609-2615
46. Ely EW, Meade MO, Haponik EF, et al: Mechanical ventilator weaning protocols driven by nonphysician health-care professionals: Evidence-based clinical practice guidelines. Chest 2001; 120:4548-4638
47. Needleman J, Buerhaus P, Mattke S, et al: Nurse-staffing levels and the quality of care in hospitals. N Engl J Med 2002; 346:1715-1722
48. Cho SH, Ketefian S, Barkauskas VH, et al: The effects of nurse staffing on adverse events, morbidity, mortality, and medical costs. Nursing Research 2003; 52:71-79
49. Fridkin SK, Pear SM, Williamson TH, et al: The role of understaffing in central venous catheter-associated bloodstream infections. Infect Control Hosp Epidemiol 1996; 17:150-158
50. Pittet D, Mourouga P, Perneger TV: Compliance with handwashing in a teaching hospital. Ann Intern Med 1999; 130:126-130
51. Archibald LK, Manning ML, Bell LM, et al: Patient density, nurse-to-patient ratio and nosocomial infection risk in a pediatric cardiac intensive care unit. Pediatr Infect Dis J 1997; 16:1045-1048
52. Pronovost PJ, Angus DC, Dorman T, et al: Physician staffing patterns and clinical outcomes in critically ill patients: A systematic review. JAMA 2002; 288:2151-2162
53. Pronovost PJ, Jenckes MW, Dorman T, et al: Organizational characteristics of intensive care units related to outcomes of abdominal aortic surgery. JAMA 1999; 281:1310-1317
54. Greene R, Thompson S, Jantsch HS, et al: Detection of pooled secretions above endotracheal tube cuffs: Value of plain radiographs in sheep and patients. Am J Roentgenol 1994; 163:1333-1337
55. Mahul P, Auboyer C, Jospe R, et al: Prevention of nosocomial pneumonia in intubated patients: Respective role of mechanical subglottic secretions drainage and stress ulcer prophylaxis. Intensive Care Med 1992; 18:20-25
56. Valles J, Artigas A, Rello J, et al: Continuous aspiration of subglottic secretions in preventing ventilator-associated pneumonia. Ann Intern Med 1995; 122:179-186
57. Kollef MH, Skubas NJ, Sundt TM: A randomized clinical trial of continuous aspiration of subglottic secretions in cardiac surgery patients. Chest 1999; 116:1339-1346
58. Smulders K, van der HH, Weers-Pothoff I, et al: A randomized clinical trial of intermittent subglottic secretion drainage in patients receiving mechanical ventilation. Chest 2002; 121:858-862
59. Holzapfel L: Nasal vs oral intubation. Minerva Anestesiologica 2003; 69:348-352
60. Bert F, Lambert-Zechovsky N: Sinusitis in mechanically ventilated patients and its role in the pathogenesis of nosocomial pneumonia. Eur J Clin Microbiol Infect Dis 1996; 15:533-544
61. Holzapfel L, Chastang C, Demingeon G, et al: A randomized study assessing the systematic search for maxillary sinusitis in nasotracheally mechanically ventilated patients. Influence of nosocomial maxillary sinusitis on the occurrence of ventilator-associated pneumonia. Am J Respir Crit Care Med 1999; 159:695-701
62. Lareau SC, Ryan KJ, Diener CF: The relationship between frequency of ventilator circuit changes and infectious hazard. Am Rev Respir Dis 1978; 118:493-496
63. Craven DE, Connolly MG Jr, Lichtenberg DA, et al: Contamination of mechanical ventilators with tubing changes every 24 or 48 hours. N Engl J Med 1982; 306:1505-1509
64. Dreyfuss D, Djedaini K, Weber P, et al: Prospective study of nosocomial pneumonia and of patient and circuit colonization during mechanical ventilation with circuit changes every 48 hours versus no change. Am Rev Respir Dis 1991; 143:738-743
65. Kollef MH, Shapiro SD, Fraser VJ, et al: Mechanical ventilation with or without 7-day circuit changes. A randomized controlled trial. Ann Intern Med 1995; 123:168-174
66. Long MN, Wickstrom G, Grimes A, et al: Prospective, randomized study of ventilator-associated pneumonia in patients with one versus three ventilator circuit changes per week. Infect Control Hosp Epidemiol 1996; 17:14-19
67. Hess D, Burns E, Romagnoli D, et al: Weekly ventilator circuit changes. A strategy to reduce costs without affecting pneumonia rates. Anesthesiology 1995; 82:903-911
68. Tablan OC, Anderson LJ, Arden NH, et al: Guideline for prevention of nosocomial pneumonia. The Hospital Infection Control Practices Advisory Committee, Centers for Disease Control and Prevention. Infect Control Hosp Epidemiol 1994; 15:587-627
69. Craven DE, Goularte TA, Make BJ: Contaminated condensate in mechanical ventilator circuits. A risk factor for nosocomial pneumonia?. Am Rev Respir Dis 1984; 129:625-628
70. Dreyfuss D, Djedaini K, Gros I, et al: Mechanical ventilation with heated humidifiers or heat and moisture exchangers: Effects on patient colonization and incidence of nosocomial pneumonia. Am J Respir Crit Care Med 1995; 151:986-992
71. Saravolatz LD, Pohlod DJ, Conway W, et al: Lack of bacterial aerosols associated with heat and moisture exchangers. Am Rev Respir Dis 1986; 134:214-216
72. Kirton OC, DeHaven B, Morgan J, et al: A prospective, randomized comparison of an in-line heat moisture exchange filter and heated wire humidifiers: Rates of ventilator-associated early-onset (community-acquired) or late-onset (hospital-acquired) pneumonia and incidence of endotracheal tube occlusion. Chest 1997; 112:1055-1059
73. Huxley EJ, Viroslav J, Gray WR, et al: Pharyngeal aspiration in normal adults and patients with depressed consciousness. Am J Med 1978; 64:564-568
74. Kollef MH: Ventilator-associated pneumonia: A multivariate analysis. JAMA 1993; 270:1965-1970
75. Ibanez J, Penafiel A, Raurich JM, et al: Gastroesophageal reflux in intubated patients receiving enterai nutrition: Effect of supine and semirecumbent positions. JPEN 1992; 16:419-422
76. Orozco-Levi M, Torres A, Ferrer M, et al: Semirecumbent position protects from pulmonary aspiration but not completely from gastroesophageal reflux in mechanically ventilated patients. Am J Respir Crit Care Med 1995; 152:1387-1390
77. Torres A, Serra-Batlles J, Ros E, et al: Pulmonary aspiration of gastric contents in patients receiving mechanical ventilation: The effect of body position. Ann Intern Med 1992; 116:540-543
78. Drakulovic MB, Torres A, Bauer TT, et al: Supine body position as a risk factor for nosocomial pneumonia in mechanically ventilated patients: A randomised trial. Lancet 1999; 354:1851-8158
79. Torres A, El-Ebiary M, Soler N, et al: Stomach as a source of colonization of the respiratory tract during mechanical ventilation: Association with ventilator-associated pneumonia. Eur Respir J 1996; 9:1729-1735
80. McClave SA, DeMeo MT, DeLegge MH, et al: North American Summit on Aspiration in the Critically Ill Patient: consensus statement. JPEN 2002; 26:S80-S85
81. Heyland DK, Drover JW, Dhaliwal R, et al: Optimizing the benefits and minimizing the risks of enterai nutrition in the critically ill: Role of small bowel feeding. JPEN 2002; 26:S51-S55
82. Ibrahim EH, Mehringer L, Prentice D, et al: Early versus late enterai feeding of mechanically ventilated patients: Results of a clinical trial. JPEN 2002; 26:174-181
83. Costerton W, Veeh R, Shirtliff M, et al: The application of biofilm science to the study and control of chronic bacterial infections. J Clin Invest 2003; 112:1466-1477
84. Fuqua WC, Greenberg EP: Listening in on bacteria: Acyl-homoserine lactone signalling. Nat Rev Mol Cell Biol 2002; 3:685-695
85. Olson ME, Harmon BG, Kollef MH: Silver-coated endotracheal tubes associated with reduced bacterial burden in the lungs of mechanically ventilated dogs. Chest 2002; 121:863-870
86. Jones DS, McGovern JG, Woolfson AD, et al: Physicochemical characterization of hexetidine-impregnated endotracheal tube poly-(vinyl chloride) and resistance to adherence of respiratory bacterial pathogens. Pharm Res 2002; 19:818-824
87. Yanagihara K, Tomono K, Imamura Y, et al: Effect of clarithromycin on chronic respiratory infection caused by Pseudomonas aeruginosa with biofilm formation in an experimental murine model. J Antimicrob Chemother 2002; 49:867-870
88. Triandafillu K, Balazs DJ, Aronsson BO, et al: Adhesion of Pseudomonas aeruginosa strains to untreated and oxygen-plasma treated poly (vinyl chloride) (PVC) from endotracheal intubation devices. Biomaterials 2003; 24:1507-1518
89. Adair CG, German SP, Byers LM, et al: Eradication of endotracheal tube biofilm by nebulized gentamicin. Intensive Care Med 2002; 28:426-431
90. Boyce JM, Pittet D: Healthcare Infection Control Practices Advisory Committee. HICPAC/SHEA/APIC/IDSA Hand Hygiene Task Force. Guideline for Hand Hygiene in Health-Care Settings. Recommendations of the Healthcare Infection Control Practices Advisory Committee and the HIPAC/SHEA/APIC/IDSA Hand Hygiene Task Force. Am J Infect Control 2002; 30:S1-S46
91. Girou E, Loyeau S, Legrand P, et al: Efficacy of handrubbing with alcohol based solution versus standard handwashing with antiseptic soap: Randomised clinical trial. BMJ 2002; 325:362
92. Pittet D, Hugonnet S, Harbarth S, et al: Effectiveness of a hospital-wide programme to improve compliance with hand hygiene. Lancet 2000; 356:1307-1312
93. Ephgrave KS, Kleiman-Wexler R, Pfaller M, et al: Effects of sucralfate vs antacids on gastric pathogens: Results of a double-blind clinical trial. Arch Surg 1998; 133:251-257
94. Stoutenbeek CP, van Saene HK: Nonantibiotic measures in the prevention of ventilator-associated pneumonia. Semin Respir Infect 1997; 12:294-299
95. Bonten MJM, Gaillard CA, van der Geest S, et al: The role of intragastric acidity and stress ulcer prophylaxis on colonization and infection in mechanically ventilated patients. A stratified, randomized, double blind study of sucralfate versus antacids. Am J Respir Crit Care Med 1995; 152:1825-1834
96. Cook D, Guyatt G, Marshall J, et al: A comparison of sucralfate and ranitidine for the prevention of upper gastrointestinal bleeding in patients requiring mechanical ventilation. N Engl J Med 1998; 338:791-797
97. Messori A, Trippoli S, Vaiani M, et al: Bleeding and pneumonia in intensive care patients given ranitidine and sucralfate for prevention of stress ulcer: Meta-analysis of randomised controlled trials. BMJ 2000; 321:1-7
98. Bonten MJM, Bergmans DCJJ, Ambergen AW, et al: Risk factors for pneumonia, and colonization of respiratory tract and stomach in mechanically ventilated ICU patients. Am J Respir Crit Care Med 1996; 154:1339-1346
99. Bergmans DC, Bonten MJ, Gaillard CA, et al: Prevention of ventilator-associated pneumonia by oral decontamination: a prospective, randomized, double-blind, placebo-controlled study. Am J Respir Crit Care Med 2001; 164:382-388
100. Abele-Horn M, Dauber A, Bauernfeind A, et al: Decrease in nosocomial pneumonia in ventilated patients by selective oropharyngeal decontamination. Intensive Care Med 1996; 23:187-195
101. Pugin J, Auckenthaler R, Lew DP, et al: Oropharyngeal decontamination decreases incidence of ventilator-associated pneumonia: A randomized, placebo-controlled, double-blind clinical trial. JAMA 1991; 265:2704-2710
102. Rodriguez-Roldan JM, Altuna-Cuesta A, Lopez A, et al: Prevention of nosocomial lung infection in ventilated patients: Use of an antimicrobial pharyngeal nonabsorbable paste. Crit Care Med 1990; 18:1239-1242
103. DeRiso AJII, Ladowski JS, Dillon TA, et al: Chlorhexidine gluconate 0.12% oral rinse reduces the incidence of total nosocomial respiratory infection and nonprophylactic systemic antibiotic use in patients undergoing heart surgery. Chest 1996; 109:1556-1561
104. Bonten MJ, Weinstein RA: Infection control in intensive care units and prevention of ventilator-associated pneumonia. Semin Respir Infect 2000; 15:327-335
105. Garcia S, Roque J, Ruza F, et al: Infection and associated risk factors in the immediate postoperative period of pediatric liver transplantation: A study of 176 transplants. Clin Transplant 1998; 12:190-197
106. D'Amico R, Pifferi S, Leonetti C, et al: Effectiveness of antibiotic prophylaxis in critically ill adult patients: Systematic review of randomised controlled trials. BMJ 1998; 316:1275-1285
107. Nathens AB, Marshall JC: Selective decontamination of the digestive tract in surgical patients: A systematic review of the evidence. Arch Surg 1999; 134:170-176
108. de Jonge E, Schultz MJ, Spanjaard L, et al: Effects of selective decontamination of digestive tract on mortality and acquisition of resistant bacteria in intensive care: A randomized controlled trial. Lancet 2003; 362:1011-1016
109. Kollef MH: Selective digestive decontamination should not be routinely employed. Chest 2003; 123:464s-468s
110. Hoth JJ, Franklin GA, Stassen NA, et al: Prophylactic antibiotics adversely affect nosocomial pneumonia in trauma patients. J Trauma Injury Infect Crit Care 2003; 55:249-254
111. Sirvent JM, Torres A, El-Ebiary M, et al: Protective effect of intravenously administered cefuroxime against nosocomial pneumonia in patients with structural coma. Am J Respir Crit Care Med 1997; 155:1729-1734
112. Rahal JJ, Urban C, Horn D, et al: Class restriction of cephalosporin use to control total cephalosporin resistance in nosocomial Klebsiella. JAMA 1998; 280:1233-1237
113. Kollef MH, Vlasnik JSL, Sharpless L, et al: Scheduled change of antibiotic classes: A strategy to decrease the incidence of VAP. Am J Respir Crit Care Med 1997; 156:1040-1048
114. Kollef MH, Ward S, Sherman G, et al: Inadequate treatment of nosocomial infections is associated with certain empiric antibiotic choices. Crit Care Med 2000; 28:3456-3464
115. Gruson D, Hubert G, Vargas F, et al: Rotation and restricted use of antibiotics in a medical intensive care unit. Am J Respir Crit Care Med 2000; 162:837-843
116. Gruson D, Hilbert G, Vargas F, et al: Strategy of antibiotic rotation: long-term effect on incidence and susceptibilities of Gram-negative bacilli responsible for ventilator-associated pneumonia. Crit Care Med 2003; 31:1908-1914
117. Raymond DP, Pelletier SJ, Crabtree TD, et al: Sawyer RG. Impact of a rotating empiric antibiotic schedule on infectious mortality in an intensive care unit. Crit Care Med 2001; 29:1101-1108
118. Burke JP: Antibiotic resistance - squeezing the balloon? JAMA 1998; 280:1270-1271
119. Singh N, Rogers P, Atwood CW, et al: Short course empiric antibiotic therapy for pulmonary infiltrates in the intensive care unit: A proposed solution for indiscriminate antibiotic prescription. Am J Respir Crit Care Med 2000; 162:505-511
120. Ibrahim EH, Ward S, Sherman G, et al: Experience with a clinical guideline for the treatment of ventilator-associated pneumonia. Crit Care Med 2001; 29:1109-1115
121. Dennesen PJ, van der Ven AJ, Kessels AG, et al: Resolution of infectious parameters after antimicrobial therapy in patients with ventilator-associated pneumonia. Am J Respir Crit Care Med 2001; 163:1371-1375
122. Chastre J, Wolff M, Fagon JY, et al: Comparison of 8 vs 15 days of antibiotic therapy for ventilator-associated pneumonia in adults. JAMA 2003; 290:2588-2598
123. Micek ST, Ward S, Fraser VJ, et al: A randomized controlled trial of an antibiotic discontinuation policy for clinically suspected ventilator-associated pneumonia. Chest, In Press
124. Klugman KP, Madhi SA, Huebner RE, et al: A trial of a 9-valent pneumococcal conjugate vaccine in children with and those without HIV infection. N Engl J Med 2003; 349:1341-1348
125. Eskola J, Kilpi T, Palmu A, et al: Finnish Otitis Media Study Group. Efficacy of a pneumococcal conjugate vaccine against acute otitis media. N Engl J Med 2001; 344:403-409
126. Nichol KL, Nordin J, Mullooly J, et al: Influenza vaccination and reduction in hospitalizations for cardiac disease and stroke among the elderly. N Engl J Med 2003; 348:1322-1332
127. Shinefield H, Black S, Fattom A, et al: Use of a Staphylococcus aureus conjugate vaccine in patients receiving hemodialysis. N Engl J Med 2002; 346:491-496
128. Vamvakas EC: Transfusion-associated cancer recurrence and postoperative infection: Meta-analysis of randomized, controlled clinical trials. Transfusion 1996; 36:175-186
129. Taylor RW, Manganaro L, O'Brien J: Impact of allogenic packed red blood cell transfusion on nosocomial infection rates in the critically ill patient. Crit Care Med 2002; 30:2249-2254
130. Tang R, Chen HH, Wang YL: Risk factors for surgical site infection after elective resection of the colon and rectum: A single-center prospective study of 2,809 consecutive patients. Ann Surg 2001; 234:181-199
131. Shorr AF, Duh M-S, Kelly KM, et al: Red blood cell transfusion and ventilator-associated pneumonia. A potential link? Crit Care Med, In Press
132. Cook D, Ricard JD, Reeve B, et al: Ventilator circuit and secretion management strategies: A Franco-Canadian survey. Crit Care Med 2000; 28:3547-3554
133. Rello J, Lorente C, Bodi M, et al: Why physicians do not follow evidence-based guidelines for preventing ventilator-associated pneumonia? A survey based on the opinions of an international panel of intensivists. Chest 2002; 122:656-661
134. Ricart M, Lorente C, Diaz E, et al: Nursing adherence with evidence-based guidelines for preventing ventilator-associated pneumonia. Crit Care Med 2003; 31:2693-2696
135. Cook DJ, Meade MO, Hand LE, et al: Toward understanding evidence uptake: Semirecumbency for pneumonia prevention. Crit Care Med 2002; 30:1472-1477
136. Helman DL, Sherner JH, Fitzpatrick TM, et al: Effect of standardized orders and provider education on head-of-bed positioning in mechanically ventilated patients. Crit Care Med 2003; 31:2285-2290
137. Babcock HM, Zack JE, Garrison T, et al: An educational intervention to reduce ventilator-associated pneumonia in an integrated health system: a comparison of effects. Chest, In Press
138. Kollef MH: The importance of appropriate initial antibiotic therapy for hospital-acquired infections. Am J Med 2003; 115:582-584