Antimicrobial Susceptibility among Pathogens Isolated in Early- versus Late-Onset Ventilator-Associated Pneumonia

Abstract

Ventilator-associated pneumonia (VAP) is associated with increased hospital stay and high morbidity and mortality in critically ill patients. The aims of this study were to (i) determine the incidence of multidrug-resistant (MDR) pathogens in the first episodes of VAP and to assess potential differences in bacterial profiles of subjects with early- versus late-onset VAP. This was a retrospective cohort study over a period of 18 months including all patients who had a first episode of VAP confirmed by positive bacterial culture. Subjects were distributed into two groups according to the number of intubation days: early-onset VAP (<5 days) or late-onset VAP (≥5 days). The primary endpoint was the nature of causative pathogens and their resistance profiles. Sixty patients were included, 29 men and 31 women, with an average age of 38 ± 16 years. The IGS 2 at admission was 40.5 [32–44] and APACHE was 19 [15–22]. Monomicrobial infections were diagnosed in 77% of patients (n = 46). The most frequently isolated bacteria were A. baumannii, 53% (n = 32); P. aeruginosa in 37% (n = 22); Enterobacterales in 28% (n = 17) and S. aureus in 5% (n = 3). Ninety-seven percent of the bacteria were MDR. The VAP group comprised 36 (60%) episodes of early-onset VAP and 24 (40%) episodes of late-onset VAP. There was no significant difference in the distribution of the bacterial isolates, nor in terms of antibacterial resistances between early- and late-onset VAPs. Our data support recent observations that there is no microbiological difference in the prevalence of potential MDR pathogens or in their resistance profiles associated with early- versus late-onset VAPs, especially in countries with high rates of MDR bacteria.

Causative bacteria of ventilator-associated pneumonia in intensive care unit in Bahrain: Prevalence and antibiotics susceptibility pattern

“…In the current study, gram-negative bacteria were the most common organisms that cause VAP, whereas Acinetobacter baumannii was the most common organism (50% of all VAP cases). This finding agrees with Ben Lakhal et al 29] , who had 53% of their cases caused by Acinetobacter baumannii [ 29 ]. Staph aureus was the causative organism in 11% of all recorded VAP cases in our study, all isolated from late-onset VAP.…”

Risk Factors and Protective Factors against Ventilator-Associated Pneumonia—A Single-Center Mixed Prospective and Retrospective Cohort Study

“…These results are in line with the previous findings of Hosamirudsari et al [40] and Wałaszek et al [9]. On the other hand, in the study conducted by Ben Lakha et al [41], Acinetobacter baumanii was the mostcommon isolated organism, followed by Pseudomonas Aeruginosa and Enterobacterales. Similar to Xie et al [8], we did not find any difference in the distribution of pathogens between early-and late-onset VAP.…”

Identification of Microbial Isolates Obtained from Patients with Ventilator-Associated Pneumonia and Their Susceptibility to Antibiotics in Misrata, Libya

“…Detected microorganisms in this study were similar to those seen in an Indonesian study where most isolates were fungi or Klebsiella species [15], while in an Indian study, most of the isolates were Pseudomonas aeruginosa [17]. According to the present study, most of the Gramnegative bacteria isolates were multi-drug resistant (MDR) and this was in agreement with two studies conducted in France and Indonesia [19,20].…”