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Research article
Apichart - So-ngern
Khon Kaen University Faculty of Medicine
Corresponding Author
ORCiD: https://orcid.org/0000-0002-3268-3008
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Back ground: Ventilator-associated pneumonia (VAP) isacommon nocosomial infection inintensive care unit (ICU). Local microbiological surveillance of pathogens and resistance patternsfor early-onset VAP (EOVAP) and late-onset VAP (LOVAP)will help to choose appropriate empiric antibiotics.
Objective: To comparethe multi-drug resistant (MDR) pathogens, treatment outcomes,and factors associated with hospital mortality of VAP.
Method:A cross-sectional studybetween 1 January 2015 and 31 December 2017 at Srinagarind hospital, KhonKaen 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. Acinetobacterbaummanii 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 lowerhospital mortality (11.9 % VS 27.7%) than LOVAP ( p< 0.05). The factor associated with hospital mortality washavingsimplified acute physiology score (SAP)≥ 40 with an adjustedodds ratio(aOR) of 2.22 (95%CI, 1.08-4.54,p = 0.02).
Conclusion: LOVAP had significantly higherMDR pathogens, MV days, ICU LOS, hospital LOS andhospital mortality than EOVAP. A broad-spectrum antibiotic to cover MDR pathogensshould be considered in LOVAP.The factor associated with hospital mortality of VAP was a SAPII score ≥ 40.
Keywords
Early-onset VAP, Late-onset VAP, Microbiology, Outcome, Mortality
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CURRENT STATUS: Published
View the published article at BMC Pulmonary Medicine.
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Editor assigned
On 17 Jan, 2021
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On 17 Jan, 2021
Editor invited
On 17 Jan, 2021
No comments provided
Editorial decision: Minor revision
On 13 Jan, 2021
Review #1 received
Received 10 Jan, 2021
Reviewers invited
Invitations sent on 05 Jan, 2021
Reviewer #1 agreed
On 05 Jan, 2021
Editor assigned
On 02 Jan, 2021
Submission checks complete
On 02 Jan, 2021
Editor invited
On 02 Jan, 2021
No comments provided
Editorial decision: Minor revision
On 13 Dec, 2020
Review #1 received
Received 24 Nov, 2020
Reviewers invited
Invitations sent on 11 Nov, 2020
Reviewer #1 agreed
On 11 Nov, 2020
Editor assigned
On 12 Oct, 2020
Submission checks complete
On 11 Oct, 2020
Editor invited
On 11 Oct, 2020
Version 1
Posted 22 Jun, 2020
No comments provided
Editorial decision: Minor revision
On 25 Sep, 2020
Review #2 received
Received 24 Sep, 2020
Reviewer #4 agreed
On 07 Sep, 2020
Review #1 received
Received 07 Sep, 2020
Reviewer #3 agreed
On 03 Sep, 2020
Reviewer #2 agreed
On 02 Sep, 2020
Reviewer #1 agreed
On 18 Aug, 2020
Reviewers invited
Invitations sent on 02 Jul, 2020
Editor assigned
On 18 Jun, 2020
First submitted
On 17 Jun, 2020
Submission checks complete
On 17 Jun, 2020
Editor invited
On 17 Jun, 2020
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Subject Areas
Pulmonology
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See the published version of this preprint at BMC Pulmonary Medicine.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Apichart - So-ngern
Khon Kaen University Faculty of Medicine
Corresponding Author
ORCiD: https://orcid.org/0000-0002-3268-3008
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Pulmonary Medicine.
No community comments so far
Editor assigned
On 17 Jan, 2021
Submission checks complete
On 17 Jan, 2021
Editor invited
On 17 Jan, 2021
No comments provided
Editorial decision: Minor revision
On 13 Jan, 2021
Review #1 received
Received 10 Jan, 2021
Reviewers invited
Invitations sent on 05 Jan, 2021
Reviewer #1 agreed
On 05 Jan, 2021
Editor assigned
On 02 Jan, 2021
Submission checks complete
On 02 Jan, 2021
Editor invited
On 02 Jan, 2021
No comments provided
Editorial decision: Minor revision
On 13 Dec, 2020
Review #1 received
Received 24 Nov, 2020
Reviewers invited
Invitations sent on 11 Nov, 2020
Reviewer #1 agreed
On 11 Nov, 2020
Editor assigned
On 12 Oct, 2020
Submission checks complete
On 11 Oct, 2020
Editor invited
On 11 Oct, 2020
Version 1
Posted 22 Jun, 2020
No comments provided
Editorial decision: Minor revision
On 25 Sep, 2020
Review #2 received
Received 24 Sep, 2020
Reviewer #4 agreed
On 07 Sep, 2020
Review #1 received
Received 07 Sep, 2020
Reviewer #3 agreed
On 03 Sep, 2020
Reviewer #2 agreed
On 02 Sep, 2020
Reviewer #1 agreed
On 18 Aug, 2020
Reviewers invited
Invitations sent on 02 Jul, 2020
Editor assigned
On 18 Jun, 2020
First submitted
On 17 Jun, 2020
Submission checks complete
On 17 Jun, 2020
Editor invited
On 17 Jun, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Pulmonology
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Pulmonary Medicine.
Back ground: Ventilator-associated pneumonia (VAP) isacommon nocosomial infection inintensive care unit (ICU). Local microbiological surveillance of pathogens and resistance patternsfor early-onset VAP (EOVAP) and late-onset VAP (LOVAP)will help to choose appropriate empiric antibiotics.
Objective: To comparethe multi-drug resistant (MDR) pathogens, treatment outcomes,and factors associated with hospital mortality of VAP.
Method:A cross-sectional studybetween 1 January 2015 and 31 December 2017 at Srinagarind hospital, KhonKaen 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. Acinetobacterbaummanii 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 lowerhospital mortality (11.9 % VS 27.7%) than LOVAP ( p< 0.05). The factor associated with hospital mortality washavingsimplified acute physiology score (SAP)≥ 40 with an adjustedodds ratio(aOR) of 2.22 (95%CI, 1.08-4.54,p = 0.02).
Conclusion: LOVAP had significantly higherMDR pathogens, MV days, ICU LOS, hospital LOS andhospital mortality than EOVAP. A broad-spectrum antibiotic to cover MDR pathogensshould be considered in LOVAP.The factor associated with hospital mortality of VAP was a SAPII score ≥ 40.
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