Use of the Anti-Pseudomonas Vaccine for Prophylaxis and Treatment of Nosocomial Infections in Patients with Severe Burn Trauma | CMAC

Use of the Anti-Pseudomonas Vaccine for Prophylaxis and Treatment of Nosocomial Infections in Patients with Severe Burn Trauma

Clinical Microbiology and Antimicrobial Chemotherapy. 2015; 17(4):301-309

​ Bagin V.A., Trofimova Yu.Yu., Rudnov V.A., Golubkova A.A., Savitzkiy A.A., Korobko I.A., Wein V.I.
burns nosocomial infections P. aeruginosa «Pseudovac» vaccine antibiotic consumption
Section
Personal Experience
Type
Journal article
Publication
Clinical Microbiology and Antimicrobial Chemotherapy. 2015; 17(4):301-309

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.

Vladimir A. Bagin

City Clinical Hospital #40, Yekaterinburg, Russia

Trofimova Yu.Yu.

Ural State Medical University, Yekaterinburg, Russia

Vladimir A. Rudnov

City Clinical Hospital #40, Yekaterinburg, Russia
Ural State Medical University, Yekaterinburg, Russia

Golubkova A.A.

Ural State Medical University, Yekaterinburg, Russia

Savitzkiy A.A.

City Clinical Hospital #40, Yekaterinburg, Russia
Ural State Medical University, Yekaterinburg, Russia

Korobko I.A.

City Clinical Hospital #40, Yekaterinburg, Russia

Wein V.I.

City Clinical Hospital #40, Yekaterinburg, Russia

  • 1. Greenhalgh D.G., Saffle J.R., Holmes J.H., et al. American burn association consensus conference to define sepsis and infection in burns. J Burn Care Res 2007; 28:776-90.
  • 2. Pavoni V., Gianesello L., Paparella L., Buoninsegni L.T., Barboni E. Outcome predictors and quality of life of severe burn patients admitted to intensive care unit. Scand J Trauma. Resuscitation and Emergency Medicine 2010, 18:24.
  • 3. Coban Y.K. Infection control in severely burned patients. World J Crit Care Med 2012; 1(4):94-101.
  • 4. American Burn Association, National Burn Repository 2014.Available from: URL: http://www.ameriburn. org/2014NBRAnnualReport.pdf.
  • 5. Keen E.F., Robinson B.J., Hospenthal D.R., Aldous W.K., Wolf S.E., Chung K.K., Murray C.K. Incidence and bacteriology of burn infections at a military burn center. Burns. 2010; 36(4):461-8.
  • 6. Vincent J.L., Rello J., Marshall J., Silva E., Anzueto A., Martin C.D., et al. EPIC II Group of Investigators. International study of the prevalence and outcomes of infection in intensive care units. JAMA 2009; 302:2323- 9.
  • 7. Rosenthal V.D., Bijie H., Maki D.G., et al. International Nosocomial Infection Control Consortium (INICC) report, data summary of 36 countries, for 2004-2009. Amer J Infection Control 2012; 40:396–407.
  • 8. Решедько Г.К., Рябкова Е.Л., Кречикова О.И., Сухорукова М.В., Шевченко О.В., Эйдельштейн М.В. и др. Резистентность к антибиотикам грамотрицательных возбудителей нозокомиальных инфекций в ОРИТ многопрофильных стационаров России. Клин микробиол антимикроб химиотер 2008; 10(2):163-79
  • 9. Руднов В.А., Бельский Д.В., Дехнич А.В., исследовательская группа РИОРИТа. Инфекции в ОРИТ России: результаты национального многоцентрового исследования. Клин микробиол антимикроб химиотер 2011; 13 (4):294-303.
  • 10. Powers J.H. Antimicrobial drug development—the past, present and future. Clin Microbiol Infect 2004; 10 (Suppl 4):23-31.
  • 11. Инструкция к препарату «Псевдовак». Доступно из: URL: http://www.biomed.pl/resources/document/Ulotki_PDF/Pseudovac_Ulotka_5U002P_13.03.2014_Al.Jerozol.pdf.
  • 12. Sakiel S., Schiller B., Buchowicz I., et al. Anti-Pseudomonas immunoglobulin. IV. Combined anti-Pseudomonas immunoglobulin and Pseudomonas vaccine immunotherapy of burned patients—clinical investigations. Arch Immunol Ther Exp (Warsz) 1984; 32:523-8.
  • 13. Сайт компании IBSS Biomed. Доступно из: URL: http://mbiotechlimited.com/content/pseudovac.
  • 14. Jeschke M.G., Kamolz L.P., Shahrokhi S., editors. Burn Care and Treatment: A Practical Guide. Vienna: Springer Vienna; 2013.
  • 15. Baux S., Mimoun M., Saade H., et al. Burns in the elderly. Burns 1989; 15:239-40.
  • 16. Endorf F.W., Gamelli R.L. Inhalation injury, pulmonary perturbations, and fluid resuscitation. J Burn Care Res 2007; 28:80-3.
  • 17. Charlson M.E., Pompei P., Ales K.L., McKenzie C.R. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chron Dis 1987; 40:373-83.
  • 18. O Collaborating Centre for Drug Statistics Methodology. ATC/DDD Index 2015. Available from: URL: http://www.whocc.no/atc_ddd_index.
  • 19. Versporten A. WHO/Europe-ESAC Project Group. Antibiotic use in eastern Europe: a cross-national database study in coordination with the WHO Regional Office for Europe. The Lancet Infectious Diseases 2014; 14:381-7.
  • 20. Савельев В.С., Гельфанд Б.Р., Яковлев С.В. Стратегия и тактика применения антимикробных средств в лечебных учреждениях России. Российские национальные рекомендации. М.; 2012.
Views
0 Abstract
0 PDF
0 Crossref citations
Shared