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Is methicillin-resistant Staphylococcus aureus a common pathogen in ventilation-associated pneumonia?: The experience

Ziad A Elnasser1, Haneen M Obeidat2, Mo'ath E Bani-Salem3

  • 1Department of Pathology and Microbiology.

Medicine
|May 20, 2021
PubMed

Insights

Gram-negative bacteria, not Staphylococcus aureus, were the primary cause of ventilator-associated pneumonia in this study. Most Gram-negative infections were multidrug-resistant, highlighting a critical challenge in intensive care units.

Area of Science:

  • Medical Microbiology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Ventilator-associated pneumonia (VAP) is a serious device-related infection in intensive care units (ICUs).
  • Methicillin-resistant Staphylococcus aureus (MRSA) is a common pathogen in VAP, but its prevalence relative to other microbes needs assessment.
  • Understanding pathogen prevalence and antimicrobial susceptibility is crucial for effective VAP management.

Purpose of the Study:

  • To determine the prevalence of Staphylococcus aureus compared to other pathogens causing VAP.
  • To analyze the antibacterial sensitivity profiles of isolated pathogens in VAP cases.
  • To identify the predominant microbial causes of VAP in a Jordanian tertiary care hospital.

Main Methods:

  • Retrospective analysis of adult VAP cases admitted to the ICU from 2012 to 2018.
  • Data extraction from the hospital's computerized system.
  • Identification of microorganisms and their susceptibility testing according to Clinical and Laboratory Standards Institute guidelines.

Main Results:

  • A total of 547 isolates were analyzed.
  • Gram-negative bacteria constituted 92.6% of isolates, with 82% being multidrug-resistant.
  • Staphylococcus aureus accounted for 6.4% of isolates, with 59% being methicillin-resistant. Gram-negative infections were significantly associated with ventilation.
  • Candida species represented 1% of isolates.
  • Staphylococcus aureus was not the predominant pathogen.

Conclusions:

  • Gram-negative bacteria are the predominant pathogens in VAP, not Staphylococcus aureus.
  • High rates of multidrug resistance among Gram-negative isolates pose a significant therapeutic challenge.
  • VAP management strategies should prioritize addressing Gram-negative infections and their resistance patterns.

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