Impact of Multidrug Resistance in Ventilator-Associated Pneumonia
Author Information
Author(s): Depuydt Pieter O, Vandijck Dominique M, Bekaert Maarten A, Decruyenaere Johan M, Blot Stijn I, Vogelaers Dirk P, Benoit Dominique D
Primary Institution: Ghent University Hospital
Hypothesis
Is multidrug resistance (MDR) in pathogens causing ventilator-associated pneumonia (VAP) an independent predictor of increased mortality?
Conclusion
The risk of MDR pathogens causing VAP is mainly determined by comorbidity and prior exposure to more than two antibiotics, and MDR was not an independent predictor of mortality.
Supporting Evidence
- MDR pathogens were involved in 27% of VAP episodes.
- 30-day mortality was 37% for MDR and 20% for non-MDR VAP.
- Previous exposure to more than two antibiotic classes was a strong predictor of MDR.
Takeaway
If someone gets pneumonia while on a ventilator and has taken a lot of antibiotics before, they might get a tougher germ that is harder to treat, but just having that tough germ doesn't mean they will definitely get worse.
Methodology
Retrospective analysis of a prospectively registered cohort of adult patients with microbiologically confirmed VAP over three years.
Potential Biases
Potential bias from different time-at-risk and comorbidity adjustments.
Limitations
The study design may have overestimated the association between antibiotic exposure and MDR due to the case-control approach.
Participant Demographics
Adult patients aged 16 years and older, with a mean age of 63 years for MDR and 58 years for non-MDR.
Statistical Information
P-Value
0.01
Confidence Interval
1.08 to 1.75
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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