Клиническая микробиология и антимикробная химиотерапия (Nov 2015)
Use of the Anti-Pseudomonas Vaccine for Prophylaxis and Treatment of Nosocomial Infections in Patients with Severe Burn Trauma
Abstract
Objective. To explore potential of anti-Pseudomonas vaccine for the prophylaxis and treatment of infections caused by Pseudomonas aeruginosa in patients with severe burn trauma. Materials and Methods. This was a pilot, singlecenter randomized, parallel group study which enrolled patients with burns involving 10 to 60% of the body surface area. A total of 24 patients have received a course of «Pseudovac» vaccine (vaccination group), and 24 patients were included in the control arm (non-vaccination group). Treatment arms were compared by mortality rate and incidence of nosocomial infections caused by P. aeruginosa and other microorganisms. Assessment of antimicrobial treatment duration and antibiotic consumption using ATC/DDD methodology was performed. Results. Incidence rate of nosocomial infections was 70.8% and 83.3% in vaccinated and non-vaccinated patients, respectively (p=0.4936). A total of 9 (37.5%) vaccinated patients and 15 (62.5%) non-vaccinated patients were found to be infected and colonized by P. aeruginosa strains (p=0.1489). The average day of Pseudomonas infection onset was 17 (14.3–28.3) and 12 (6.9–21.1) in vaccinated and non-vaccinated patients, respectively (p=0.0726). The difference in mortality rate was not significant between the groups (12.5% and 25% of patients, respectively; p=0.4613). There was 9.3% decrease in antibiotic consumption (from 667 to 610 NDDD/1000 bed-days) in vaccinated patients. There were no significant changes in a total number of patients who received anti-pseudomonas antibiotics. The overall consumption of imipenem, meropenem, amikacin, cefepime, and piperacillin/tazobactam was reduced by 84.5% (from 190 to 103 NDDD/1000 bed-days). Conclusions. The «Pseudovac» vaccine used for the prophylaxis and treatment of infections caused by P. aeruginosa in patients with burns was shown to be safe. The use of anti-pseudomonas vaccine may contribute to reducing consumption of anti-pseudomonas agents.
