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Updated: Sep 17, 2025
Murine Oropharyngeal Aspiration Model of Ventilator-associated and Hospital-acquired Bacterial Pneumonia
Published on: June 28, 2018
Characteristics of ventilator-associated pneumonia due to Gram-negative bacteria in the intensive care unit: A
Sinem Bayrakçi1, Ahmet Şahin2, Onur Bayrakçi3
1Department of Intensive Care Unit, Gaziantep City Hospital, Gaziantep, Turkey.
Abstract:
Ventilator-associated pneumonia (VAP) is one of the most common and serious infections in hospitalized patients. VAP is associated with worse outcomes and significant morbidity and mortality worldwide. Our primary goal in this study was to identify the VAP pathogen with its distribution characteristics, clarify risk factors, prognosis, and outcomes, and help reduce associated morbidity and mortality. This retrospective observational study was conducted between June 2019 and June 2022 in 3 general intensive care units of a training and research hospital. Data on demographic, clinical and laboratory parameters were collected retrospectively from medical cards and electronic records. A total of 204 patients were diagnosed with VAP caused by Gram-negative microorganisms. Chronic renal failure (RF) and neurological diseases were significantly associated with mortality (P = .01, P = .023). The duration of mechanical ventilation before VAP and the duration of mechanical ventilation were significantly longer in survivors compared to non-survivors. The number of patients with early VAP was significantly higher, and the days of VAP were shorter in the non-survivors compared to the survivors (P = .006, P = .016). The number of VAP episodes (P = .0001), the presence of RF, acute respiratory distress syndrome, bacteremia, and sepsis before VAP (<48 hours) were associated with mortality. Intensive care unit and the length of hospital stay were significantly shorter in non-survivors than in survivors (P = .0003, P = .0001). Administration of monotherapy, inadequate empirical antibiotic therapy, inadequate antibiotic therapy (P = .004, P = .002, and P = .0006), persistence of the pathogen (P = .0001), C-reactive protein and procalcitonin levels (P = .002, P = .041) were associated with mortality. The presence of neurological diseases and RF was associated with a greater likelihood of mortality in patients with VAP. As risk factors, early-onset VAP, presence of RF-acute respiratory distress syndrome-bacteremia-sepsis 48 hours before VAP, organ failure, need for hemodialysis, shock and the persistence of the pathogen increased the risk of mortality.
Insights
Ventilator-associated pneumonia (VAP) is a serious hospital infection. Key risk factors for mortality include chronic renal failure and neurological diseases, highlighting the need for targeted interventions.
Area of Science:
- Critical Care Medicine
- Infectious Diseases
- Hospital Epidemiology
Background:
- Ventilator-associated pneumonia (VAP) is a prevalent and severe hospital-acquired infection.
- VAP significantly contributes to increased morbidity, mortality, and healthcare costs globally.
- Effective management requires understanding its causative pathogens, risk factors, and patient outcomes.
Purpose of the Study:
- To identify VAP pathogens and their distribution.
- To clarify risk factors, prognosis, and outcomes associated with VAP.
- To provide data to reduce VAP-related morbidity and mortality.
Main Methods:
- Retrospective observational study conducted over three years (June 2019-June 2022).
- Data collected from 3 general intensive care units.
- Analysis of demographic, clinical, and laboratory parameters from medical records of 204 VAP patients.
Main Results:
- Gram-negative microorganisms were the primary cause of VAP.
- Chronic renal failure and neurological diseases were significantly linked to mortality.
- Factors like early-onset VAP, pre-VAP conditions (bacteremia, sepsis), and pathogen persistence increased mortality risk.
Conclusions:
- Identifying specific risk factors like renal failure and neurological conditions is crucial for VAP patient management.
- Early detection and appropriate antibiotic therapy are vital for improving VAP outcomes.
- Further research into pathogen characteristics and treatment strategies can mitigate VAP's impact.
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