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Updated: Aug 23, 2025
Murine Oropharyngeal Aspiration Model of Ventilator-associated and Hospital-acquired Bacterial Pneumonia
Published on: June 28, 2018
Risk factors for ventilator-associated pneumonia due to multi-drug resistant organisms after cardiac surgery in
Meizhu Wang1, Xi Xu2, Shuo Wu2
1Department of Disease Control and Prevention, Xijing Hospital, Fourth Military Medical University, 710032, Xi'an, China.
Background:
Ventilator-associated pneumonia (VAP) is one of the most common intensive care unit (ICU)-acquired infections, which can cause multiple adverse events. Due to bacterial mutation and overuse of antimicrobial drugs, multidrug-resistant organisms (MDRO) has become one of the major causes of postoperative VAP infections in cardiac patients. Therefore, this study aims to explore the risk factors for VAP with MDRO following cardiac surgery in adults.
Methods:
The clinical data of adult VAP patients following cardiac surgery in the hospital from Jan 2017 to May 2021 were analyzed retrospectively, and the patients were divided into the MDRO VAP group and the non-MDRO VAP group. Univariable and multivariable logistic regression analyses were performed on risk factors in patients with MDRO VAP. The species and drug sensitivity of pathogens isolated from the VAP patients were also analyzed.
Results:
A total of 61 VAP cases were involved in this study, with 34 cases in the MDRO VAP group (55.7%) and 27 cases in the non-MDRO VAP group (44.3%). Multivariable logistic regression analysis showed that independent risk factors for MDRO VAP included preoperative creatinine clearance rate (CCR) ≥ 86.6ml, intraoperative cardiopulmonary bypass (CPB) time ≥ 151 min, postoperative acute kidney injury (AKI) and nasal feeding. Gram-negative bacilli were the main pathogens in VAP patients (n = 54, 90.0%), with the highest rate of Acinetobacter baumannii (n = 24, 40.0%). Additionally, patients with MDRO VAP had a significantly longer postoperative intensive care unit (ICU) duration and higher hospitalization costs than non-MDRO VAP patients, but there was no notable difference in the 28-day mortality rate between the two groups.
Conclusion:
Based on implementing measures to prevent VAP, clinicians should pay more attention to patients with kidney disease, longer intraoperative CPB time, and postoperative nasal feeding to avoid MDRO infections.
Insights
Multidrug-resistant organism (MDRO) ventilator-associated pneumonia (VAP) in cardiac surgery patients is linked to kidney function, longer cardiopulmonary bypass (CPB) times, and nasal feeding. Early intervention for these risk factors is crucial for preventing MDRO VAP.
Area of Science:
- Critical Care Medicine
- Infectious Diseases
- Surgical Infections
Background:
- Ventilator-associated pneumonia (VAP) is a common intensive care unit (ICU) infection.
- Multidrug-resistant organisms (MDRO) are increasingly causing VAP in cardiac surgery patients due to bacterial mutation and antimicrobial overuse.
Purpose of the Study:
- To identify risk factors for MDRO VAP in adult cardiac surgery patients.
- To analyze the characteristics of pathogens causing VAP in this population.
Main Methods:
- Retrospective analysis of clinical data from adult VAP patients post-cardiac surgery (Jan 2017-May 2021).
- Patients were categorized into MDRO VAP and non-MDRO VAP groups.
- Univariable and multivariable logistic regression analyses were used to determine risk factors for MDRO VAP.
Main Results:
- Independent risk factors for MDRO VAP included preoperative creatinine clearance rate (CCR) ≥ 86.6 ml/min, intraoperative cardiopulmonary bypass (CPB) time ≥ 151 min, postoperative acute kidney injury (AKI), and nasal feeding.
- Gram-negative bacilli, particularly Acinetobacter baumannii, were the predominant pathogens.
- MDRO VAP patients experienced longer ICU stays and higher hospitalization costs, but no significant difference in 28-day mortality.
Conclusions:
- Clinicians should focus on patients with impaired kidney function, prolonged CPB times, and those receiving nasal feeding to prevent MDRO VAP.
- Implementing targeted preventive measures is essential to reduce the incidence of MDRO infections post-cardiac surgery.
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