Table 2 Characteristics, diagnostic results and outcome in suspected cases of commensal oropharyngeal flora caused ventilator-associated pneumonia

1

M

Respiratory failure

0.0

COF 6*10⁴

No growth

COF few

Co-trimoxazole −7-27

Some COF possibly resistant to antibiotics

COF-VAP

92^a

60

11.6

Piperacillin −7-27

2

F

Abdominal sepsis

0.0

COF 5*10⁴

Specimen storage lacking

P. aeruginosa heavy

Piper/tazob −4-11

Tracheostomy

COF-VAP or

31

77

87.2

P. aeruginosa 2*10³, sensitive to piper/tazob

C. albicans few

P. aeruginosa VAP

3

F

Abdominal sepsis

8.2

COF 2*10⁵

R. dentocariosa 2*10²

S. aureus heavy

Piper/tazob 0-2

Nocturnal CPAP for OSAS

COF-VAP

60

57

85.6

S. oralis 7*10²

Vancomycin 2-9

S. aureus 6*10²

4

F

Post cardiac arrest

10.8

COF 10⁵

S. constellatus 10⁶

S. milleri heavy

Piper/tazob 0-3

Possible aspiration

COF-VAP

33

67

34.6

S. milleri 10⁵

S. epidermidus 3*10³

Penicillin 3-8

5

M

Multi-trauma

2.5

COF 4*10⁴

S. mitis/oralis 5*10³

No growth

Amoxi/clav acid 1-8

Chronic obstructive pulmonary disease

COF-VAP

16

47

91.5

N. mucosa 10³

C. sputigena 5*10²

6

M

Neurological

4.8

COF 10⁵

S. mitis/oralis 5*10³

Citrobacter spp. few

Piper/tazob 0-6

COF-VAP

15

23

68.2

S. aureus 10³

S. aureus 2*10³

E. cloacae 10³

S. anginosus 10³

7

M

Multi-trauma

8.8

P. melaninogenetica 10⁵

Specimen storage lacking

COF few

Metronidazole 1-7

P. melaninogenetica not susceptible to Metronidazole

COF-VAP

9

39

90.8

8

M

Pneumococcal pneumonia

2.0

COF 10⁵

Specimen storage lacking

P. aeruginosa moderate

Ciprofloxacin 0-13

Tracheostomy. Pulmonary rehabilitation clinic.

COF-VAP

134

64

21.2

P. aeruginosa 2*10²

9

M

Respiratory failure

1.4

COF 3*10⁴

Specimen storage lacking

COF few

Gentamicin 0

Tracheostomy

COF-VAP

47^a

67

23.6

Ciprofloxacin −5-8

Post-mortem exam: severe chronic fibrotic inflammation and active pneumonia

Metronidazole −5-8

Vancomycin −5-8

10

M

Respiratory failure

0.2

COF 10⁵

No growth

C. albicans rare

Ciprofloxacin −14-0

Lobectomy for aspergilloma. Imposible to wean from MV.

COF-VAP

70^a

62

99.6

C. albicans 10⁵

Piper/tazob −2-3

Fluconazole 3-17

11

M

Cerebral hemorrhage

16

COF 10⁴

L. acidophilus 10²

H. influenza few

Piper/tazob 0-2

COF-VAP

11

31

95.4

P. melaninogenetica 2*10²

Amoxi/clav acid 2-8

12

M

Sepsis

0.0

COF >10⁵

M. morganii 2*10³

M. morganii moderate

Flucloxacilline −22- -3

COF-VAP

42^a

80

15.4

S. malthophilia 5*10²

C. albicans moderate

Rifampicine −17- -10

K. pneumonia few

Piper/tazob −3 -10

Co-trimoxazole 3-10

13

M

Post cardiothoracic surgery

19.6

COF 3*10⁴

S. anginosis 10³

COF moderate

Piper/tazob 0-8

COF-VAP

63^a

71

56.2

S. constellatus 10³

C. freundii moderate

N. mucosa 10²

14

M

Multi-trauma

3.4

COF 10⁵

E. faecalis 6*10²

COF heavy

Piper/tazob 0-1

Tracheostomy

COF-VAP

62

41

44.4

P. aeruginosa 7*10³

S. mitis/oralis 5*10²

P. aeruginosa heavy

Amoxi/clav acid 1-7

15

M

Respiratory failure

NP

COF 10⁴

E. faecalis 2*10⁴

COF few

Co-trimoxazole −25 -13

Aids. ADV ct 17. CMV ct 37. P. jirovecii +. CT-thorax suggestive for PcP. Post-mortem exam: active pneumonia, possibly PcP, ADV and CMV.

PcP CAP, ADV CAP, and/or E.faecalis VAP

44^a

40

NP

S. hominis 2*10²

Piper/tazob 0-7

Vancomycin 0-8

16

F

Respiratory failure

0.0

COF 10⁵

No growth

COF few

Piper/tazob −14- -4

Ileus. Post-mortem exam: faecal peritonitis. No pneumonia. Culture -

Abdominal sepsis

4^a

55

78.0

C. glabrata 4*10²

C. albicans

Ciprofloxacin −3-1

C. albicans 2*10²

Vancomycin −2-2

17

F

Post abdominal surgery

0.0

COF 3*10⁴

Specimen storage lacking

COF few

Missing data

COF-VAP

13

70

68.0

18

M

Post neurological surgery

1.6

COF 2*10⁴

S. aureus 3*10³

S. aureus heavy

Piper/tazob ?-0

COF-VAP or S. aureus VAP

17

58

94.4

S. aureus 3*10³, sensitive to piper/tazob

Flucloxacillin 0-10

Gentamicin 3-5

19

M

Post-cardiothoracic surgery

0.0

COF 5*10⁴

Specimen storage lacking

COF few

Piper/tazob −8 - -1

Tracheostomy

COF-VAP

81

73

2.8

K. pneumoniae

Meropenem −1-7

20

M

Multi-trauma

19.4

COF 10⁴

H. influenza 10⁶

H. influenza heavy

Amoxi/clav acid −5- -4

Possible aspiration

H. influenza CAP

62

49

95.0

E. coli 4*10³

OF few

Piper/tazob 0-5

N. subflava 4*10³

S. aureus few

Gentamicin 4

21

F

Post cardiac arrest

0.0

COF 10⁴

E. faecium 5*10³

COF heavy

Piper/tazob 0-3

B- cel CLL. PIV-3 ct 19.

PIV-3 CAP or E. faecium VAP

22^a

45

1.0

E. faecalis 9*10²

Vancomycin 0-3

Post-mortem exam: active pneumonia. Cultures: CNS, E. faecium and Candida spp.

S. epidermidis 6*10²

Meropenem 2-3

22

F

Cerebral hemorrhage

7.4

COF 10⁴

C. koseri 10⁶

COF heavy

Vancomycin 0-2

C. koseri resistant to vancomycin. Possible aspiration.

C. koseri VAP

3^a

58

85.6

C. glabrata 10³

23

M

Respiratory failure

NP

COF 10⁴

S. mitis/oralis 10⁴

COF few

Amoxi/clav acid −18- -2

Admitted with bilateral pneumonia. M. pneumoniae on day 7 (ct 23. IgG +)

M. pneumoniae CAP

11

25

NP

S. haemolyticus 10³

Ciprofloxacin −8- -2

N. subflava 6*10²

Azitromycin 0-4