The impact of antimicrobial resistance and aging in VAP outcomes: experience from a large tertiary care center.
<h4>Background</h4>Ventilator associated pneumonia (VAP) is a serious infection among patients in the intensive care unit (ICU).<h4>Methods</h4>We reviewed the medical charts of all patients admitted to the adult intensive care units of the Massachusetts General Hospital that...
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| Language: | English |
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Public Library of Science (PLoS)
2014-01-01
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| Series: | PLoS ONE |
| Online Access: | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0089984&type=printable |
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| author | Marios Arvanitis Theodora Anagnostou Themistoklis K Kourkoumpetis Panayiotis D Ziakas Athanasios Desalermos Eleftherios Mylonakis |
| author_facet | Marios Arvanitis Theodora Anagnostou Themistoklis K Kourkoumpetis Panayiotis D Ziakas Athanasios Desalermos Eleftherios Mylonakis |
| author_sort | Marios Arvanitis |
| collection | DOAJ |
| description | <h4>Background</h4>Ventilator associated pneumonia (VAP) is a serious infection among patients in the intensive care unit (ICU).<h4>Methods</h4>We reviewed the medical charts of all patients admitted to the adult intensive care units of the Massachusetts General Hospital that went on to develop VAP during a five year period.<h4>Results</h4>200 patients were included in the study of which 50 (25%) were infected with a multidrug resistant pathogen. Increased age, dialysis and late onset (≥ 5 days from admission) VAP were associated with increased incidence of resistance. Multidrug resistant bacteria (MDRB) isolation was associated with a significant increase in median length of ICU stay (19 vs. 16 days, p=0.02) and prolonged duration of mechanical ventilation (18 vs. 14 days, p=0.03), but did not impact overall mortality (HR 1.12, 95% CI 0.51-2.46, p=0.77). However, age (HR 1.04 95% CI 1.01-1.07, p=0.003) was an independent risk factor for mortality and age ≥ 65 years was associated with increased incidence of methicillin-resistant Staphylococcus aureus (MRSA) infections (OR 2.83, 95% CI 1.27-6.32, p=0.01).<h4>Conclusions</h4>MDRB-related VAP is associated with prolonged ICU stay and mechanical ventilation. Interestingly, age ≥ 65 years is associated with MRSA VAP. |
| first_indexed | 2024-12-23T20:42:19Z |
| format | Article |
| id | doaj.art-81d961935c00468c8e5217f50a5057ef |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2025-03-17T00:28:30Z |
| publishDate | 2014-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-81d961935c00468c8e5217f50a5057ef2025-02-21T05:37:24ZengPublic Library of Science (PLoS)PLoS ONE1932-62032014-01-0192e8998410.1371/journal.pone.0089984The impact of antimicrobial resistance and aging in VAP outcomes: experience from a large tertiary care center.Marios ArvanitisTheodora AnagnostouThemistoklis K KourkoumpetisPanayiotis D ZiakasAthanasios DesalermosEleftherios Mylonakis<h4>Background</h4>Ventilator associated pneumonia (VAP) is a serious infection among patients in the intensive care unit (ICU).<h4>Methods</h4>We reviewed the medical charts of all patients admitted to the adult intensive care units of the Massachusetts General Hospital that went on to develop VAP during a five year period.<h4>Results</h4>200 patients were included in the study of which 50 (25%) were infected with a multidrug resistant pathogen. Increased age, dialysis and late onset (≥ 5 days from admission) VAP were associated with increased incidence of resistance. Multidrug resistant bacteria (MDRB) isolation was associated with a significant increase in median length of ICU stay (19 vs. 16 days, p=0.02) and prolonged duration of mechanical ventilation (18 vs. 14 days, p=0.03), but did not impact overall mortality (HR 1.12, 95% CI 0.51-2.46, p=0.77). However, age (HR 1.04 95% CI 1.01-1.07, p=0.003) was an independent risk factor for mortality and age ≥ 65 years was associated with increased incidence of methicillin-resistant Staphylococcus aureus (MRSA) infections (OR 2.83, 95% CI 1.27-6.32, p=0.01).<h4>Conclusions</h4>MDRB-related VAP is associated with prolonged ICU stay and mechanical ventilation. Interestingly, age ≥ 65 years is associated with MRSA VAP.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0089984&type=printable |
| spellingShingle | Marios Arvanitis Theodora Anagnostou Themistoklis K Kourkoumpetis Panayiotis D Ziakas Athanasios Desalermos Eleftherios Mylonakis The impact of antimicrobial resistance and aging in VAP outcomes: experience from a large tertiary care center. PLoS ONE |
| title | The impact of antimicrobial resistance and aging in VAP outcomes: experience from a large tertiary care center. |
| title_full | The impact of antimicrobial resistance and aging in VAP outcomes: experience from a large tertiary care center. |
| title_fullStr | The impact of antimicrobial resistance and aging in VAP outcomes: experience from a large tertiary care center. |
| title_full_unstemmed | The impact of antimicrobial resistance and aging in VAP outcomes: experience from a large tertiary care center. |
| title_short | The impact of antimicrobial resistance and aging in VAP outcomes: experience from a large tertiary care center. |
| title_sort | impact of antimicrobial resistance and aging in vap outcomes experience from a large tertiary care center |
| url | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0089984&type=printable |
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