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Characteristics of patients with ventilator-associated pneumonia caused by multidrug resistant (n = 52) and non-MDR (n = 140) pathogens* |
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| Characteristics |
MDR (n = 52) |
Non-MDR (n = 140) |
p value |
|
|
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| Demographics |
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| Age, years |
63 ± 13 |
58 ± 17 |
0.07 |
| Male gender |
41 (79%) |
97 (69%) |
0.37 |
| Characteristics before VAP |
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| Charlson index |
2 (1 to 3) |
1 (0 to 3) |
< 0.001 |
| APACHE II upon ICU admission |
22 ± 9 |
20 ± 9 |
0.37 |
| Coma on ICU admission |
6 (12%) |
54 (39%) |
< 0.001 |
| Shock on ICU admission |
20 (38%) |
56(40%) |
0.87 |
| ARDS before VAP |
25 (48%) |
29 (21%) |
0.001 |
| RRT before VAP |
14 (27%) |
18 (13%) |
0.03 |
| Duration of ventilation before VAP, days |
9 (5 to 19) |
7 (4 to 13) |
0.008 |
| Duration hospitalisation before VAP, days |
0 (0 to 6) |
0 (0 to 1) |
0.001 |
| Antibiotic exposure before VAP |
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| No antibiotics |
6 (11%) |
32 (23%) |
0.11 |
| 1 antibiotic class |
15 (29%) |
73 (52%) |
0.005 |
| 2 antibiotic classes |
13 (25%) |
24 (17%) |
0.22 |
| > 2 antibiotic classes |
18 (35%) |
11 (8%) |
< 0.001 |
| SOFA 2 days before VAP |
5 (3 to 8) |
5 (3 to 8) |
0.83 |
| Characteristics of VAP |
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| SOFA at VAP |
7 (3 to 10) |
6 (4 to 9) |
0.27 |
| Delta SOFA□ |
0.6 ± 3.3 |
0.6 ± 3.5 |
0.88 |
| VAP with shock |
15 (29%) |
26 (19%) |
0.16 |
| Gram-negative aetiology |
40 (77%) |
122 (87%) |
0.39 |
| Enterobacteriaceae |
28 (54%) |
66 (46%) |
0.07 |
| Pseudomonas aeruginosa |
11 (21%) |
40 (29%) |
0.98 |
| Non-fermenter other than P. aeruginosa |
1 (2%) |
4 (3%) |
0.32 |
| Other Gram-negative† |
0 |
12 (9%) |
0.001 |
| Gram-positive aetiology |
12 (23%) |
18 (13%) |
0.39 |
| Staphylococcus aureus |
12 (23%) |
13 (9%) |
0.14 |
| Streptococcus pneumoniae |
0 |
5 (3%) |
0.01 |
| Appropriate therapy < 24 hours |
41 (79%) |
122 (87%) |
0.16 |
| Appropriate therapy < 48 hours |
45 (87%) |
133 (95%) |
0.05 |
| Subsequent VAP |
10 (19%) |
24 (17%) |
0.83 |
| Outcome parameters: |
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| ICU-length of stay following VAP, days |
18 (8 to 37) |
15 (8 to 29) |
0.34 |
| Died 30 days after VAP diagnosis |
19 (37%) |
28 (20%) |
0.02 |
| Died at ICU |
22 (42%) |
29 (21%) |
0.006 |
| Died in hospital |
28 (54%) |
41 (29%) |
0.001 |
| Discharged to other hospital and lost to follow up |
2 |
3 |
|
| Referred to chronic health care facility |
0 |
4 |
|
| Still hospitalised at time of analysis |
4 |
3 |
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*Data are presented as mean ± SD, median (25th to 75th percentile) or number (%). □Delta SOFA: SOFA two days after VAP minus SOFA two days before VAP. † Other Gram-negative: Haemophilus influenzae in 11, Moraxella catarrhalis in 1. ◇β-lactam antibiotics (penicillins and cephalosporins), carbapenems, fluoroquinolones, aminoglycosides, glycopeptides and linezolid, other antibiotics (cotrimoxazole, colistin). APACHE = Acute Physiology and Chronic Health Evaluation; ARDS = acute respiratory distress syndrome; ICU, Intensive Care Unit; MDR, Multidrug-resistant; RRT, Renal Replacement Therapy; SOFA = sequential organ failure assessment; VAP, Ventilator-associated Pneumonia. | |||
Depuydt et al. Critical Care 2008 12:R142 doi:10.1186/cc7119 |
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