Comparison of microbiological profile of pathogens isolated from early-onset and late-onset ventilator-associated pneumonia in a tertiary care center

Jakribettu, Ramakrishna Pai; Boloor, Rekha; Suresh, Sarasija

doi:10.4103/1119-0388.172073

Cited by 7 publications

(8 citation statements)

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“…These studies, however, did not address the causative pathogens into EOVAP and LOVAP. Three studies from different tertiary-care centers of India had results similar to our study [ 14 , 15 , 29 ]. A. baumannii , K. pneumonia and P. aeruginosa were common pathogens in both EOVAP and LOVAP.…”

Section: Discussionsupporting

confidence: 88%

“…VAP was categorized into early-onset VAP (EOVAP) and late-onset VAP (LOVAP) depending upon when it occurred on which days after hospitalization. The cutoff point of a range 4-7 days onset varied across the studies [11][12][13][14][15][16]. Recent guideline for HAP and VAP management from The Infectious Disease Society of America (IDSA)/American Thoracic Society (ATS) and the International ERS/ESICM/ESCMID/ALAT use the cutoff point of 5 days after hospitalization [2,17,18].…”

Section: Introductionmentioning

confidence: 99%

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Microorganisms and clinical outcomes of early- and late-onset ventilator-associated pneumonia at Srinagarind Hospital, a tertiary center in Northeastern Thailand

et al. 2021

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Background Ventilator-associated pneumonia (VAP) is a common nocosomial infection in intensive care unit (ICU). Local microbiological surveillance of pathogens and resistance patterns for early-onset VAP (EOVAP) and late-onset VAP (LOVAP) will help to choose appropriate empiric antibiotics. Objective To compare the multi-drug resistant (MDR) pathogens, treatment outcomes, and factors associated with hospital mortality of VAP. Method A cross-sectional study between 1 January 2015 and 31 December 2017 at Srinagarind hospital, Khon Kaen University was conducted. The demographic data, causative pathogens, hospital length of stay (LOS), ICU LOS, mechanical ventilator (MV) days, and hospital mortality were retrospectively reviewed. Results One hundred and ninety patients were enrolled; 42 patients (22%) were EOVAP and 148 patients (78%) were LOVAP. Acinetobacter baumannii was the most common pathogen in both groups (50% EOVAP vs 52.7% LOVAP). MDR pathogens were significant greater in LOVAP (81.8%) than EOVAP (61.9%) (p = 0.007). The EOVAP had a significantly better ICU LOS [median (interquartile range, IQR) 20.0 (11.0, 30.0) vs. 26.5 (17.0, 43.0) days], hospital LOS [median (IQR) 26.5 (15.0, 44.0) vs. 35.5 (24.0, 56.0) days] shorter MV days [median (IQR) 14.0 (10.0, 29.0) vs. 23.0 (14.0, 35.5) days] and lower hospital mortality (16.7% vs 35.1%) than LOVAP (p < 0.05). The factor associated with hospital mortality was having simplified acute physiology (SAP) II score ≥ 40 with an adjusted odds ratio (aOR) of 2.22 [95% confidence interval (CI), 1.08–4.54, p = 0.02]. Conclusion LOVAP had significantly higher MDR pathogens, MV days, ICU LOS, hospital LOS and hospital mortality than EOVAP. A broad-spectrum antibiotic to cover MDR pathogens should be considered in LOVAP. The factor associated with hospital mortality of VAP was a SAPII score ≥ 40.

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Section: Discussionsupporting

confidence: 88%

Section: Introductionmentioning

confidence: 99%

Microorganisms and clinical outcomes of early- and late-onset ventilator-associated pneumonia at Srinagarind Hospital, a tertiary center in Northeastern Thailand

et al. 2021

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“…These studies, however, did not address the causative organisms into early-onset VAP and late-onset VAP. Three studies from different tertiarycare centers of India had results similar to the present study [13,14,28]. A. baumannii, K. pneumonia and P. aeruginosa were common pathogens in both EOVAP and LOVAP.…”

Section: Discussionsupporting

confidence: 86%

Microorganisms and clinical outcomes of early- and late-onset ventilator-associated pneumonia at Srinagarind Hospital, a tertiary center in Northeastern Thailand

Arayasukawat

So-ngern

Reechaipichitkul

et al. 2021

Preprint

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Background: Ventilator-associated pneumonia (VAP) is a common nocosomial infection in intensive care unit (ICU). Local microbiological surveillance of pathogens and resistance patterns for early-onset VAP (EOVAP) and late-onset VAP (LOVAP) will help to choose appropriate empiric antibiotics. Objective: To compare the multi-drug resistant (MDR) pathogens, treatment outcomes, and factors associated with hospital mortality of VAP. Method: A cross-sectional study between 1 January 2015 and 31 December 2017 at Srinagarind hospital, Khon Kaen University was conducted. The demographic data, causative pathogens, hospital length of stay (LOS), ICU LOS, mechanical ventilator (MV) days, and hospital mortality were retrospectively reviewed. Results: One hundred and ninety patients were enrolled; 42 patients (22%) were EOVAP and 148 patients (78%) were LOVAP. Acinetobacter baumannii was the most common pathogen in both groups (50 % EOVAP vs 52.7% LOVAP). MDR pathogens were significant greater in LOVAP (81.8 %) than EOVAP (61.9%) (p = 0.007). The EOVAP had a significantly better ICU LOS (median (interquartile range, IQR) 20.0 (11.0, 30.0) vs. 26.5 (17.0, 43.0) days), hospital LOS (median (IQR) 26.5 (15.0, 44.0) vs. 35.5 (24.0, 56.0) days) shorter MV days (median (IQR) 14.0 (10.0, 29.0) vs. 23.0 (14.0, 35.5) days) and lower hospital mortality (16.7% VS 35.1%) than LOVAP (p < 0.05). The factor associated with hospital mortality was having simplified acute physiology (SAP) II score ≥ 40 with an adjusted odds ratio (aOR) of 2.22 (95% confidence interval (CI), 1.08-4.54, p = 0.02). Conclusion: LOVAP had significantly higher MDR pathogens, MV days, ICU LOS, hospital LOS and hospital mortality than EOVAP. A broad-spectrum antibiotic to cover MDR pathogens should be considered in LOVAP. The factor associated with hospital mortality of VAP was a SAPII score ≥ 40.

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“…These studies, however, did not address the causative organisms into early-onset VAP and late-onset VAP. Three studies from different tertiarycare centers of India had results similar to the present study [14,15,29]. A. baumannii, K. pneumonia and P. aeruginosa were common pathogens in both EOVAP and LOVAP.…”

Section: Discussionsupporting

confidence: 86%

Microorganisms and clinical outcomes of early- and late-onset ventilator-associated pneumonia at Srinagarind Hospital, a tertiary center in Northeastern Thailand

Tamura

Kumamaru

Abe

et al. 2020

Preprint

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Back ground: Ventilator-associated pneumonia (VAP) is a common nocosomial infection in intensive care unit (ICU). Local microbiological surveillance of pathogens and resistance patterns for early-onset VAP (EOVAP) and late-onset VAP (LOVAP) will help to choose appropriate empiric antibiotics. Objective: To compare the multi-drug resistant (MDR) pathogens, treatment outcomes, and factors associated with hospital mortality of VAP. Method: A cross-sectional study between 1 January 2015 and 31 December 2017 at Srinagarind hospital, Khon Kaen University was conducted. The demographic data, causative pathogens, hospital length of stay (LOS), ICU LOS, mechanical ventilator (MV) days, and hospital mortality were retrospectively reviewed. Results: One hundred and ninety patients were enrolled; 42 (22%) were EOVAP and 148 (78%) were LOVAP. Acinetobacter baummanii was the most common pathogen in both groups (50 % EOVAP vs 52.7% LOVAP). MDR pathogens were significant greater in LOVAP (81.8 %) than EOVAP (61.9%) (p = 0.007). The EOVAP had a significantly better ICU LOS (median 20.0 (11.0, 30.0) vs. 26.5 (17.0, 43.0) days), hospital LOS (median 26.5 (15.0, 44.0) vs. 35.5 (24.0, 56.0) days) shorter MV days (14.0 (10.0, 29.0) vs. 23.0 (14.0, 35.5) days) and lower hospital mortality (11.9 % VS 27.7%) than LOVAP ( p < 0.05). The factor associated with hospital mortality was having simplified acute physiology score (SAP) ≥ 40 with an adjusted odds ratio (aOR) of 2.22 (95%CI, 1.08-4.54, p = 0.02). Conclusion: LOVAP had significantly higher MDR pathogens, MV days, ICU LOS, hospital LOS and hospital mortality than EOVAP. A broad-spectrum antibiotic to cover MDR pathogens should be considered in LOVAP. The factor associated with hospital mortality of VAP was a SAPII score ≥ 40.

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Comparison of microbiological profile of pathogens isolated from early-onset and late-onset ventilator-associated pneumonia in a tertiary care center

Cited by 7 publications

References 0 publications

Microorganisms and clinical outcomes of early- and late-onset ventilator-associated pneumonia at Srinagarind Hospital, a tertiary center in Northeastern Thailand

Microorganisms and clinical outcomes of early- and late-onset ventilator-associated pneumonia at Srinagarind Hospital, a tertiary center in Northeastern Thailand

Microorganisms and clinical outcomes of early- and late-onset ventilator-associated pneumonia at Srinagarind Hospital, a tertiary center in Northeastern Thailand

Microorganisms and clinical outcomes of early- and late-onset ventilator-associated pneumonia at Srinagarind Hospital, a tertiary center in Northeastern Thailand

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