Microorganisms and Clinical Outcomes of Early- and Late-onset Ventilator-associated Pneumonia at Srinagarind Hospital, a Tertiary Center in Northeastern Thailand

Overview

Journal BMC Pulm Med

Publisher Biomed Central

Specialty Pulmonary Medicine

Date 2021 Jan 31

PMID 33516213

Citations 7

Authors

Pavarit Arayasukawat

Apichart So-Ngern

Wipa Reechaipichitkul

Worawat Chumpangern

Itthiphat Arunsurat

Pailin Ratanawatkul

Wanna Chuennok

Affiliations

Soon will be listed here.

Abstract

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.

Citing Articles

Etiology of Hospital-Acquired Pneumonia (HAP) and Ventilator-Associated Pneumonia (VAP) in Tertiary-Care Hospitals in Thailand: A Multicenter, Retrospective Cohort Study.

Rongrungruang Y, Plongla R, Pleumkanitkul S, Hantrakun V, Khawcharoenporn T Infect Drug Resist. 2025; 18:351-361.

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A new model of endotracheal tube biofilm identifies combinations of matrix-degrading enzymes and antimicrobials able to eradicate biofilms of pathogens that cause ventilator-associated pneumonia.

Walsh D, Parmenter C, Bakker S, Lithgow T, Traven A, Harrison F Microbiology (Reading). 2024; 170(8).

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Multidrug-resistant pathogens and ventilator-associated pneumonia in critically ill COVID-19 and non-COVID-19 patients: a prospective observational monocentric comparative study.

Montrucchio G, Balzani E, Sales G, Vaninetti A, Grillo F, Trompeo A Respir Res. 2024; 25(1):168.

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Treatment and Management of Pneumonia: Lessons Learned from Recent World Event.

Rangel K, De-Simone S Infect Drug Resist. 2024; 17:507-529.

PMID: 38348231 PMC: 10860873. DOI: 10.2147/IDR.S431525.

Antimicrobial Solutions for Endotracheal Tubes in Prevention of Ventilator-Associated Pneumonia.

Marcut L, Manescu Paltanea V, Antoniac A, Paltanea G, Robu A, Mohan A Materials (Basel). 2023; 16(14).

PMID: 37512308 PMC: 10386556. DOI: 10.3390/ma16145034.

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