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Sir,

Several studies among patients undergoing cardiac surgery (CS) have reported post-operative pneumonia (POP) as the main infectious complication1,2 usually involving nosocomial microorganisms.1 Due to the therapeutic issues raised by Pseudomonas aeruginosa infections, the choice of appropriate initial empirical antibiotic therapy (EAT) is of major importance, but has been minimally addressed in CS patients. We compared the incidence, risk factors, microbiological features, therapeutic management and outcome of POP due to P. aeruginosa with POP due to other organisms in this setting.

This single-centre study performed in a tertiary care hospital from January 2005 to October 2007 prospectively evaluated 2540 patients undergoing CS with cardiopulmonary bypass admitted to a post-operative 15 bed CS intensive care unit (ICU). Cefamandole was used for surgical antibiotic prophylaxis (allergic patients received vancomycin + gentamicin). Diagnosis of POP was based on usual clinical and microbiological criteria, with bronchoalveolar lavage yielding bacteria at a concentration of >104 cfu/mL or protected distal bronchial specimen samples yielding >103 cfu/mL. Susceptibility testing was performed using the disc diffusion method.3

Issue Section:
Research Letters
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