Ventilator-associated pneumonia: MDR Gram-negative bacteria and predictors of mortality : [skaitytas pranešimas]

Abstract

Introduction: The aim of study was to evaluate antimicrobial resistance of Gram-negative bacteria (GNB) as pathogens of ventilator-associated pneu-monia (VAP) and to determinate predictors of in-hospital mortality.MethodsRetrospective data analysis of patients treated in ICU with multidrug-resistant strains of GNB as pathogens of VAP during 2015 was carriedout.ResultsIn 77 VAP pts 98 multidrug-resistant strains of GNB were revealed: 37(37.8%) of A. baumannii, 16 (16.3%) of Klebsiella spp., 11(11.2%) ofEnterobacter spp., 10 (10.2%) of P. aeruginosa and others 24 (24.5%)as S. marcescens, Morganella spp., Citrobacter spp., E. coli, Proteusspp. In 34 (34.7%) of GNB strains multidrug-resistance (MDR), in 63(64.3%) extensive drug-resistance (XDR) and in 1 (1%) pandrug-resistance (PDR) was ascertained. MDR was found in 7 (63.6%) of En-terobacter spp. and 7 (70%) of P. aeruginosa (p < 0.001), XDR - in 36(97.3%) of A. baumannii strains (p < 0.001). One (10%) of P. aerugi-nosa strains was found to be PDR. 37 (48%) pts with multidrug-resistant pathogens of VAP have died. Statistical significant differ-ences of survivors vs nonsurvivors were found in means of hospital-isation days prior of VAP 53.8 (SD = 34) vs 29,1 (SD = 17), p = 0.001,neutrophils percent 81 (SD = 8.9) vs 85 (SD = 6.3), p = 0.045, and be-tween proportions of internal disease 7 (33%) vs 14 (67%), p = 0.042,co-infection 13 (30%) vs 30 (70%), p = 0.001, shock 16 (36%) vs 28(64%), p = 0.03, multiple organ dysfunction syndrome 17 (40%) vs 25(60%), p = 0.039, inappropriate initial antimicrobial treatment 18(40%) vs 27 [...].