Ventilator Associated Pneumonia in Pediatric Intensive Care Unit: Incidence, Risk Factors and Etiological Agents

Gnanaguru, Vijay; Mandal, Anirban; Sankar, Jhuma; Kapil, Arti; Lodha, Rakesh; Kabra, S. K.

doi:10.1007/s12098-018-2662-8

Cited by 45 publications

(57 citation statements)

References 20 publications

(24 reference statements)

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“…Existing literature from Indian studies suggests an incidence of VAP ranging from 13–42%, and is highly variable in different regions [ 21 ]. Incidence rate reported in the developing countries is 25–35%, while in developed countries is 15–17% [ 22 ]. Majority of patients were in age group of 40–60 years with preponderance of male sex (69.2% or 199/172), similar findings have been published in various studies [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

Emergence of blaNDM-1 and blaVIM producing Gram-negative bacilli in ventilator-associated pneumonia at AMR Surveillance Regional Reference Laboratory in India

et al. 2021

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Introduction Ventilator-associated pneumonia (VAP) may be a life threatening nosocomial infection encountered in intensive care units. Currently the emergence of carbapenem-resistant Gram-negative pathogens has become worrisome threat worldwide. Material and methods Endotracheal aspirates samples were collected from patients who were under mechanical ventilation for > 48 h. The bacterial isolates were identified by MALDI-TOF-MS and antibiotic susceptibility testing performed. All carbapenem resistant isolates were tested by Modified Hodge test (MHT), modified carbapenem inactivation method (mCIM), and EDTA-CIM (eCIM) and PCR were performed to detect blaIMP, blaVIM and blaNDM producing MBL genes. Results VAP occurred in 172/353(48.7%), 23.3% had early-onset VAP and 76.7% had late-onset VAP. Males (69.2%) were found to suffer more from VAP. Prior antibiotic therapy, CPI>6, prior surgery and tracheostomy were associated with VAP. The mortality in VAP (58.1%) contrasted with non-VAP (40%). 99/169 (58.6%) Gram-negative isolates were resistant to carbapenems. Acinetobacter baumannii, Pseudomonas aeruginosa and Klebsiella pneumoniae were common pathogens found in late onset VAP, whereas K. pneumoniae, A. baumannii and Staphylococcus aureus were common in early onset VAP. The PCR results detected blaNDM in 37/172(21.5%) and blaVIM in 30/172(17.4%); 15/172(8.7%) isolates carried both genes. Conclusion The blaNDM-1 and blaVIM genes are the main antibiotic-resistance genes that induce resistance patterns to carbapenems in VAP, highlighting CRE strains of potential public health concern and therapeutic challenge. Diagnostic laboratories in India must get on high caution for early MBL detection as it may limit the wide dispersal of MBL genes.

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Section: Discussionmentioning

confidence: 99%

Emergence of blaNDM-1 and blaVIM producing Gram-negative bacilli in ventilator-associated pneumonia at AMR Surveillance Regional Reference Laboratory in India

et al. 2021

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“…Since critical pediatric patients often have immune deficiency and severe underlying disease, and require long-time hospitalization and invasive procedures, the incidence rate of Ab infection and the drug resistance rate of Ab are generally higher in a pediatric intensive care unit (PICU) than in other wards [3,4]. A. baumannii has become a major conditioned pathogenic bacterium of VAP in several PICUs and accounts for 34.7-47.0% of isolated strains [5,6].…”

Section: Introductionmentioning

confidence: 99%

Mechanical ventilation-associated pneumonia caused by Acinetobacter baumannii in Northeast China region: analysis of genotype and drug resistance of bacteria and patients’ clinical features over 7 years

Zhang

et al. 2021

Antimicrob Resist Infect Control

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Objective To investigate the clinical features and outcomes of patients with mechanical ventilation-associated pneumonia (VAP) caused by Acinetobacter baumannii (Ab), and to characterize the drug resistance of pathogenic strains and carbapenem resistance-associated genes. Methods Clinical data were collected from the PICU of Shengjing Hospital. Patients who met the diagnostic criteria of VAP and for whom Ab was a pathogen were selected as study participants. The patients were divided into carbapenem-resistant A. baumannii (CRAB) and carbapenem-sensitive A. baumannii (CSAB) groups. The genes closely associated with Ab resistance to carbapenems and the efflux pump-related genes were detected by real-time polymerase chain reaction, and results compared between the two groups. Results The total mechanical ventilation time and the administration time of antibiotics after a diagnosis of Ab infection were significantly higher in the CRAB group. And the CRAB group strains were only sensitive to amikacin, cephazolin, compound sulfamethoxazole, and tigecycline. Genetic test results indicated that IPM expression was not significantly different between two groups. The OXA-51 and OXA-23 in the CRAB group was markedly higher than that in the CSAB group, while OXA-24 expression was markedly lower. The expression of AdeABC and AdeFGH was significantly greater in the CRAB compared to CSAB group. Conclusion In pediatric patients with VAP caused by Ab infection, the detection rate of CRAB strains is far higher than that of CSAB strains; The abnormal expression of β-lactamase-producing genes (OXA-23, OXA-24, and OXA-51) and efflux pump-related genes (AdeABC and AdeFGH) is closely related to the production of CRAB.

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“…Se produce por distintos mecanismos, principalmente a través del tubo endotraqueal o traqueostomía, pero también por aspiración de secreciones colonizadas procedentes de la orofaringe, por vía hematógena a partir de focos de infección distantes o de la flora intestinal a través de translocación bacteriana y por contigüidad desde infecciones adyacentes a los pulmones4. El conocimiento de su patogenia, características epidemiológicas y factores de riesgo, nos permiten tomar medidas preventivas para disminuir los casos, sabiendo que la prevención de NAV es un objetivo nacional de seguridad del paciente, y constituye un indicador de calidad de la atención 4,5,6 .…”

Section: Introductionunclassified

Neumonía asociada a ventilación mecánica en la unidad de cuidados intensivos pediátricos de un hospital terciario 2015-2018

Cieza-Yamunaqué¹,

Coila-Paricahua²

2019

RFMH

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Introducción: La neumonía asociada a ventilador (NAV) aumenta 2 a 3 veces el riesgo de mortalidad. Objetivo: Conocer características de NAV, determinar tasas de infección, gérmenes aislados, sensibilidad antibiótica y mortalidad. Métodos: Estudio descriptivo, retrospectivo en pacientes con NAV 2015-2018. Los datos se obtuvieron del programa Rikchary de una unidad de cuidados intensivos pediátricos. Resultados: Se registraron 60 casos de NAV, con tasas promedio anuales de 9.8 por 1000 días ventilación mecánica (VM). El 65% fueron tardías diagnosticadas después de 5 días de VM. Los días de VM promedio fueron de 15, reingresaron a VM el 25%. Los gérmenes más frecuentes fueron Stenotrophomona maltophilia sensible 81% al cotrimoxazol y Pseudomona aureginosa sensible 80% al cefepime, 90% a amikacina y entre el 50% a 60% a los carbapenemens. La mortalidad fue del 15%. Conclusión: La tasa anual promedio de NAV en el servicio evaluado se encuentra dentro de estándares internacionales, el tipo más frecuente la tardía fue más frecuente en menores de 6 meses y sexo masculino. La desnutrición, cardiopatía congénita, tiempo de ventilación mecánica, días de hospitalización y cirugías se encontraron en mayor proporción en pacientes con NAV. Los gram negativos fueron los más frecuentes y la mortalidad 15%. Palabras clave: Neumonía asociada al ventilador; Infección hospitalaria; Unidades de cuidado intensivo pediátrico.

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Ventilator Associated Pneumonia in Pediatric Intensive Care Unit: Incidence, Risk Factors and Etiological Agents

Cited by 45 publications

References 20 publications

Emergence of blaNDM-1 and blaVIM producing Gram-negative bacilli in ventilator-associated pneumonia at AMR Surveillance Regional Reference Laboratory in India

Emergence of blaNDM-1 and blaVIM producing Gram-negative bacilli in ventilator-associated pneumonia at AMR Surveillance Regional Reference Laboratory in India

Mechanical ventilation-associated pneumonia caused by Acinetobacter baumannii in Northeast China region: analysis of genotype and drug resistance of bacteria and patients’ clinical features over 7 years

Neumonía asociada a ventilación mecánica en la unidad de cuidados intensivos pediátricos de un hospital terciario 2015-2018

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