Ventilator-Associated Pneumonia Caused by Carbapenem-Resistant Gram-Negative Bacteria in a Pediatric Intensive Care Unit

Deniz M., ŞENOL H., Erat T., Ari H. F., Altug U., KIRAL E., ...More

JOURNAL OF PEDIATRIC INTENSIVE CARE, 2023 (ESCI) identifier

  • Publication Type: Article / Article
  • Publication Date: 2023
  • Doi Number: 10.1055/s-0043-1772818
  • Journal Name: JOURNAL OF PEDIATRIC INTENSIVE CARE
  • Journal Indexes: Emerging Sources Citation Index (ESCI)
  • Keywords: ventilator-associated pneumonia, pediatric intensive care unit, antibiotic resistance, antimicrobial stewardship, carbapenem-resistant, ACINETOBACTER-BAUMANNII, RISK-FACTORS, MULTIDRUG-RESISTANT, DRUG-RESISTANT
  • Eskisehir Osmangazi University Affiliated: Yes

Abstract

We aimed to analyze risk factors of ventilator-associated pneumonia (VAP) caused by multidrug-resistant (MDR), pan-drug-resistant (PDR), and extensively drug-resistant (XDR) gram-negative bacteria (GNB) in a pediatric intensive care unit (PICU). This retrospective study evaluated pediatric patients diagnosed with VAP at a tertiary referral hospital. Of the 46 children in the present study, 40 (86.9%) had VAP caused by MDR-, XDR-, and PDR-GNB. Most patients (60.9%) had spent >28 days in the PICU at the time of diagnosis. Respiratory failure necessitating PICU admission was associated with XDR infection-induced VAP ( p = 0.034). High rates of prior broad-spectrum antibiotic use were observed in patients with XDR GNB-induced VAP. VAP induced by MDR-, XDR-, and PDR-GNB occurred more frequently than that caused by drug-susceptible GNB in PICU patients. Long stays for more than 28 days in the PICU and past use of broad-spectrum antibiotics can lead to the development of XDR-GNB-induced VAP. The high antibiotic resistance rates detected in our study highlight the importance of strict infection control measures and antimicrobial stewardship programs in PICUs.