• C Aubron, A Chaari, R Bronchard, L Armand-Lefèvre, P Montravers, B Régnier, M Wolff, and J-C Lucet.
• Service de Réanimation Médicale, Groupe Hospitalier Bichat-Claude-Bernard, Assistance Publique-Hôpitaux de Paris, Université Xavier-Bichat, 46, rue Henri-Huchard, 75877 Paris Cedex 18, France. c.aubron@free.fr
• J. Hosp. Infect. 2011 Jan 1; 77 (1): 64-9.

AbstractThe impact of high level cephalosporin resistance due to Enterobacteriaceae harbouring a type I-inducible chromosomal β-lactamase on the outcome of ventilator-associated pneumonia (VAP) remains unknown. A retrospective cohort study was conducted in two intensive care units (ICUs) over a four-year period to identify factors prognostic of VAP caused by high level AmpC (HL-AmpC)-producing Enterobacteriaceae. The study included 75 patients, who developed VAP due to Enterobacteriaceae harbouring a type I-inducible chromosomal β-lactamase. One-third of these VAP episodes were due to HL-AmpC-producing Enterobacteriaceae. Demographic and clinical characteristics at ICU admission were similar for patients, regardless of Enterobacteriaceae susceptibility, but those who developed VAP due to HL-AmpC-producing Enterobacteriaceae received antibiotics more frequently before its onset and had higher disease severity and organ dysfunction scores. Enterobacter spp. were the major HL-AmpC-producing micro-organisms responsible for VAP. VAP due to HL-AmpC-producing Enterobacteriaceae is rare. High level cephalosporin resistance was not associated with higher day 28 mortality, despite its association with more severe disease at VAP onset.Copyright © 2010 The Hospital Infection Society. Published by Elsevier Ltd. All rights reserved.

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