Microorganisms and Clinical Outcomes of Early- and Late-onset Ventilator-associated Pneumonia at Srinagarind Hospital, a Tertiary Center in Northeastern Thailand
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.
On 13 Jan, 2021
Received 10 Jan, 2021
Invitations sent on 05 Jan, 2021
On 05 Jan, 2021
On 02 Jan, 2021
On 02 Jan, 2021
On 02 Jan, 2021
On 13 Dec, 2020
Received 24 Nov, 2020
Invitations sent on 11 Nov, 2020
On 11 Nov, 2020
On 12 Oct, 2020
On 11 Oct, 2020
On 11 Oct, 2020
Posted 22 Jun, 2020
On 25 Sep, 2020
Received 24 Sep, 2020
On 07 Sep, 2020
Received 07 Sep, 2020
On 03 Sep, 2020
On 02 Sep, 2020
On 18 Aug, 2020
Invitations sent on 02 Jul, 2020
On 18 Jun, 2020
On 17 Jun, 2020
On 17 Jun, 2020
On 17 Jun, 2020
Microorganisms and Clinical Outcomes of Early- and Late-onset Ventilator-associated Pneumonia at Srinagarind Hospital, a Tertiary Center in Northeastern Thailand
On 13 Jan, 2021
Received 10 Jan, 2021
Invitations sent on 05 Jan, 2021
On 05 Jan, 2021
On 02 Jan, 2021
On 02 Jan, 2021
On 02 Jan, 2021
On 13 Dec, 2020
Received 24 Nov, 2020
Invitations sent on 11 Nov, 2020
On 11 Nov, 2020
On 12 Oct, 2020
On 11 Oct, 2020
On 11 Oct, 2020
Posted 22 Jun, 2020
On 25 Sep, 2020
Received 24 Sep, 2020
On 07 Sep, 2020
Received 07 Sep, 2020
On 03 Sep, 2020
On 02 Sep, 2020
On 18 Aug, 2020
Invitations sent on 02 Jul, 2020
On 18 Jun, 2020
On 17 Jun, 2020
On 17 Jun, 2020
On 17 Jun, 2020
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.