[Bacterial etiology of nosocomial pneumonia and antimicrobial resistance in patients with and without antimicrobial treatment].

Nosocomial pneumonia (NP) is associated with high morbimortality, representing the second cause of nosocomial infection after urinary tract infection. The objective of this work was to become acquainted with the etiology of NP and to evaluate the antimicrobial resistance profile of the isolated microorganisms from adult patients with and without previous antimicrobial treatment admitted in the intensive care unit (ICU). From 2000 to 2005, 430 bronchoalveolar lavages from 430 adult patients diagnosed with pneumonia admitted in the ICU were analyzed. Seventy-four percent (199/ 269) of the patients with previous treatment had positive cultures, whereas in the group without previous treatment the percentage was 83% (134/161) (p = 0,03). The main agents in both groups of patients were: Acinetobacter spp. (37.9% vs 36.1%), Staphylococcus aureus (21.3% vs 26.6% ) and Pseudomonas aeruginosa (20.9% vs 17.7%), respectively (p > 0,05). The antimicrobial resistance in Acinetobacter spp., P. aeruginosa and S. aureus from previously treated patients was higher than that from patients without previous antimicrobial treatment (p < 0,05), except in the case of trimethoprim-sulfamethoxazole in S. aureus (p = 0,29). In conclusion, previous antimicrobial treatment did not modify the etiology of NP, but caused an increase in overall antimicrobial resistance and a lower percentage of positive cultures.