The clinical and microbiological efficacy of vancomycin in the combination treatment of newborns with ventilator-associated pneumonia caused by gram-positive cocci
Abstract
The paper deals with nosocomlal ventilator-associated pneumonia caused by gram-positive cocci in full-term and preterm newborns and with a trial of the clinical and microbiological efficacy of the antibiotic vancomycin. Thirteen full-term neonates and 46 preterm ones were examined. Most newborn infants (78—93%) were found to have monoinfection caused by gram-positive cocci, mainly Staphylococcus spp. and Enterococcus faecalis. Vancomycin was highly effective against the coccal microflora with the minimum inhibitory concentration (MIC) of <2 ug/ml against Staphylococcus spp. and Group В Streptococcus in 46 newborns, moderately effective with the MIC of 24 ug/ml, but s8 ug/ml against Enterococcus faecalis m9 infants and ineffective or lowly effective with the MIC of 216 ug/ml against Enterococcus faecium in 4 infants. However, secondary infection caused by the hospital strains of gram-negative microorganisms (predominantly Enterobacteriaceae and Pseudomonasaeruginosae) generally inducing mixed infection occurred in 41% of the infants on 5—7 day of the disease. In this connection, most children were given vancomycin in combination with beta-lactam antibiotics or amikacin.
About the Authors
M. V. Kushnareva
Research Clinical Institute of Pediatrics; Maternity Hospital Fifteen, Moscow
Russian Federation
Russian Federation
G. M. Dementyeva
Research Clinical Institute of Pediatrics; Maternity Hospital Fifteen, Moscow
Russian Federation
Russian Federation
A. Yu. Gerasimov
Research Clinical Institute of Pediatrics; Maternity Hospital Fifteen, Moscow
Russian Federation
Russian Federation
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Review
For citations:
Kushnareva M.V., Dementyeva G.M., Gerasimov A.Yu. The clinical and microbiological efficacy of vancomycin in the combination treatment of newborns with ventilator-associated pneumonia caused by gram-positive cocci. Rossiyskiy Vestnik Perinatologii i Pediatrii (Russian Bulletin of Perinatology and Pediatrics). 2014;59(2):71-77. (In Russ.)
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