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Published on: February 23, 2014
Risk factors of multidrug-resistant bacteria infection in patients with ventilator-associated pneumonia: A systematic
Jian-Nan Hu1, Sheng-Qi Hu2, Zi-Ling Li1
1Department of Respiratory and Critical Care Medicine, Key Laboratory of Pulmonary Diseases of Health Ministry, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
Background:
Multidrug-resistant (MDR) bacteria-induced VAP often has high lethality. We present this systematic review and meta-analysis to assess the risk factors for MDR bacterial infection in patients with VAP.
Methods:
PubMed, EMBASE, Web of Science, and Cochrane Library were searched for studies regarding MDR bacterial infection in VAP patients, from Jan 1996 to Aug 2022. Study selection, data extraction, and quality assessment of included studies were conducted by two reviewers independently, and potential risk factors for MDR bacterial infection were identified.
Results:
Meta-analysis showed that the score of the Acute Physiology and Chronic Health Evaluation II (APACHE-II) [OR = 1.009, 95% (CI 0.732, 1.287)], Simplified Acute Physiology Score II (SAPS-II) [OR = 2.805, 95%CI (0.854, 4.755)], length of hospital-stay before VAP onset (days) [OR = 2.639, 95%CI (0.387, 4.892)], in-ICU duration [OR = 3.958, 95%CI (0.894, 7.021)], Charlson index [OR = 1.000, 95%CI (0.889, 1.111)], overall hospital-stay [OR = 20.742, 95%CI (18.894, 22.591)], Medication of Quinolones [OR = 2.017, 95%CI (1.339, 3.038)], medication of carbapenems [OR = 3.527, 95%CI (2.476, 5.024)], combination of more than 2 prior antibiotics [OR = 3.181, 95%CI (2.102, 4.812)], and prior use of antibiotics [OR 2.971, 95%CI (2.001, 4.412)] were independent risk factors of MDR bacterial infection in VAP patients. Diabetes and mechanical ventilation duration before VAP onset showed no association with risk for MDR bacterial infection.
Conclusions:
This study has identified 10 risk factors associated with MDR bacterial infection in VAP patients. Identification of these factors would be able to facilitate the treatment and prevention of MDR bacterial infection in clinical practice.
Insights
Multidrug-resistant bacteria in ventilator-associated pneumonia (VAP) are deadly. This review identified 10 risk factors, including prior antibiotic use and longer hospital stays, to aid in VAP treatment and prevention.
Area of Science:
- Infectious Diseases
- Critical Care Medicine
- Epidemiology
Background:
- Ventilator-associated pneumonia (VAP) caused by multidrug-resistant (MDR) bacteria presents a significant clinical challenge with high mortality rates.
- Identifying risk factors for MDR bacterial infections in VAP is crucial for effective management and prevention strategies.
Conclusions:
- This study successfully identified 10 significant risk factors contributing to MDR bacterial infections in VAP.
- The findings provide valuable insights for clinicians to better target prevention efforts and optimize treatment strategies for VAP patients at risk of MDR infections.
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