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Pseudomonas aeruginosa can be an indolent colonizer in the respiratory tract or a highly virulent invader. In a study conducted in San Francisco ICUs from October 2002 through April 2006, researchers investigated the effects of P. aeruginosa colonization on outcomes among critically ill adults intubated for ≥48 hours (n=1901).
Daily surveillance cultures of endotracheal aspirates revealed P. aeruginosa in 216 patients. Among the 69 patients found to have new colonization, 45 developed high P. aeruginosa burdens (≥106 CFU/mL in tracheal aspirate or ≥104 CFU/mL in bronchoalveolar lavage fluid) — 27 of them ≤48 hours after enrollment, and 18 of them later (mean, 4 days after study enrollment). Ventilator-associated pneumonia (VAP) attributed t…