Mechanical Ventilator-Associated Pneumonia in the COVID-19 Pandemic Era: A Critical Challenge in the Intensive Care Units
<b>Background/Objectives:</b> Ventilator-associated pneumonia (VAP) is the most common nosocomial infection encountered in the intensive care unit (ICU) and is associated with prolonged hospitalization and increased mortality. We evaluated the causative pathogens involved and their resis...
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2025-01-01
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| author | Mircea Stoian Adina Andone Sergiu Rareș Bândilă Danusia Onișor Sergiu Ștefan Laszlo Gabriela Lupu Alina Danielescu Dragoș-Florin Baba Anca Meda Văsieșiu Andrei Manea Adina Stoian |
| author_facet | Mircea Stoian Adina Andone Sergiu Rareș Bândilă Danusia Onișor Sergiu Ștefan Laszlo Gabriela Lupu Alina Danielescu Dragoș-Florin Baba Anca Meda Văsieșiu Andrei Manea Adina Stoian |
| author_sort | Mircea Stoian |
| collection | DOAJ |
| description | <b>Background/Objectives:</b> Ventilator-associated pneumonia (VAP) is the most common nosocomial infection encountered in the intensive care unit (ICU) and is associated with prolonged hospitalization and increased mortality. We evaluated the causative pathogens involved and their resistance to the major classes of antibiotics in patients with VAP and assessed the differences between patients with and without coronavirus disease 2019 (COVID-19). <b>Materials and Methods</b>: This study was a single-center, cross-sectional, retrospective analysis involving 122 patients who were hospitalized in the ICU of Târgu Mureș County Clinical Hospital from 1 April 2021, to 1 April 2023. This study compares patients with VAP in COVID-19 and non-COVID-19 groups, examining the clinical progression, duration of ventilation and hospitalization, mortality, pathogen distribution, and the emergence of multidrug-resistant strains. <b>Results:</b> A length of stay in the ICU exceeding 11.5 days was associated with the development of multidrug-resistant (MDR) infections (AUC: 0.708, <i>p</i> < 0.001). Similarly, a duration of MV exceeding 196 h was associated with MDR acquisition (AUC: 0.695, <i>p</i> = 0.002). Additionally, a Clinical Pulmonary Infection Score (CPIS) greater than 5 was associated with MDR development (AUC: 0.854, <i>p</i> < 0.001) in the whole group of patients. The most commonly isolated strains were <i>Acinetobacter</i> spp., <i>Pseudomonas</i> spp., Klebsiella spp., and <i>Staphylococcus aureus</i>. Among non-COVID-19 patients, there was a notably higher frequency of MDR <i>Acinetobacter baumannii</i>. A bacterial resistance to carbapenems was found in <i>Acinetobacter</i> spp. (51.6%), <i>Klebsiella</i> spp. (22.6%), and <i>Pseudomonas</i> spp. (25.8%). <b>Conclusions:</b> COVID-19 patients experienced longer ventilation, higher mortality, and an increased risk of developing MDR. Carbapenem resistance was universal in <i>Acinetobacter</i> spp. and <i>Klebsiella pneumoniae</i>, whereas resistance in <i>Pseudomonas aeruginosa</i> was more prevalent among non-COVID-19 patients. The Clinical Pulmonary Infection Score (CPIS) strongly correlates with developing MDR pathogens in both patient groups. |
| format | Article |
| id | doaj-art-a0dc278f96bb47848efad442303420c3 |
| institution | Kabale University |
| issn | 2079-6382 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | MDPI AG |
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| series | Antibiotics |
| spelling | doaj-art-a0dc278f96bb47848efad442303420c32025-01-24T13:18:37ZengMDPI AGAntibiotics2079-63822025-01-011412810.3390/antibiotics14010028Mechanical Ventilator-Associated Pneumonia in the COVID-19 Pandemic Era: A Critical Challenge in the Intensive Care UnitsMircea Stoian0Adina Andone1Sergiu Rareș Bândilă2Danusia Onișor3Sergiu Ștefan Laszlo4Gabriela Lupu5Alina Danielescu6Dragoș-Florin Baba7Anca Meda Văsieșiu8Andrei Manea9Adina Stoian10Department of Anesthesiology and Intensive Care, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology of Târgu Mures, 540139 Targu Mures, RomaniaGastroenterology Department, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology of Târgu Mures, 540142 Targu Mures, RomaniaOrthopedic Surgery and Traumatology Service, Marina Baixa Hospital, Av. Alcade En Jaume Botella Mayor, 03570 Villajoyosa, SpainGastroenterology Department, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology of Târgu Mures, 540142 Targu Mures, RomaniaIntensive Care Unit, Mures Clinical County Hospital, Street Gheorghe Marinescu No 1, 540103 Targu Mures, RomaniaIntensive Care Unit, Mures Clinical County Hospital, Street Gheorghe Marinescu No 1, 540103 Targu Mures, RomaniaIntensive Care Unit, Mures Clinical County Hospital, Street Gheorghe Marinescu No 1, 540103 Targu Mures, RomaniaDepartment of Cell and Molecular Biology, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540142 Targu Mures, RomaniaInfectious Disease, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology of Targu Mures, 540136 Targu Mures, RomaniaDoctoral School of Medicine and Pharmacy, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540139 Targu Mures, RomaniaDepartment of Pathophysiology, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology of Targu Mures, 540136 Targu Mures, Romania<b>Background/Objectives:</b> Ventilator-associated pneumonia (VAP) is the most common nosocomial infection encountered in the intensive care unit (ICU) and is associated with prolonged hospitalization and increased mortality. We evaluated the causative pathogens involved and their resistance to the major classes of antibiotics in patients with VAP and assessed the differences between patients with and without coronavirus disease 2019 (COVID-19). <b>Materials and Methods</b>: This study was a single-center, cross-sectional, retrospective analysis involving 122 patients who were hospitalized in the ICU of Târgu Mureș County Clinical Hospital from 1 April 2021, to 1 April 2023. This study compares patients with VAP in COVID-19 and non-COVID-19 groups, examining the clinical progression, duration of ventilation and hospitalization, mortality, pathogen distribution, and the emergence of multidrug-resistant strains. <b>Results:</b> A length of stay in the ICU exceeding 11.5 days was associated with the development of multidrug-resistant (MDR) infections (AUC: 0.708, <i>p</i> < 0.001). Similarly, a duration of MV exceeding 196 h was associated with MDR acquisition (AUC: 0.695, <i>p</i> = 0.002). Additionally, a Clinical Pulmonary Infection Score (CPIS) greater than 5 was associated with MDR development (AUC: 0.854, <i>p</i> < 0.001) in the whole group of patients. The most commonly isolated strains were <i>Acinetobacter</i> spp., <i>Pseudomonas</i> spp., Klebsiella spp., and <i>Staphylococcus aureus</i>. Among non-COVID-19 patients, there was a notably higher frequency of MDR <i>Acinetobacter baumannii</i>. A bacterial resistance to carbapenems was found in <i>Acinetobacter</i> spp. (51.6%), <i>Klebsiella</i> spp. (22.6%), and <i>Pseudomonas</i> spp. (25.8%). <b>Conclusions:</b> COVID-19 patients experienced longer ventilation, higher mortality, and an increased risk of developing MDR. Carbapenem resistance was universal in <i>Acinetobacter</i> spp. and <i>Klebsiella pneumoniae</i>, whereas resistance in <i>Pseudomonas aeruginosa</i> was more prevalent among non-COVID-19 patients. The Clinical Pulmonary Infection Score (CPIS) strongly correlates with developing MDR pathogens in both patient groups.https://www.mdpi.com/2079-6382/14/1/28mechanical ventilationnosocomial infectionsviral and bacterial co-infectionsventilator-associated pneumoniamultidrug-resistance |
| spellingShingle | Mircea Stoian Adina Andone Sergiu Rareș Bândilă Danusia Onișor Sergiu Ștefan Laszlo Gabriela Lupu Alina Danielescu Dragoș-Florin Baba Anca Meda Văsieșiu Andrei Manea Adina Stoian Mechanical Ventilator-Associated Pneumonia in the COVID-19 Pandemic Era: A Critical Challenge in the Intensive Care Units Antibiotics mechanical ventilation nosocomial infections viral and bacterial co-infections ventilator-associated pneumonia multidrug-resistance |
| title | Mechanical Ventilator-Associated Pneumonia in the COVID-19 Pandemic Era: A Critical Challenge in the Intensive Care Units |
| title_full | Mechanical Ventilator-Associated Pneumonia in the COVID-19 Pandemic Era: A Critical Challenge in the Intensive Care Units |
| title_fullStr | Mechanical Ventilator-Associated Pneumonia in the COVID-19 Pandemic Era: A Critical Challenge in the Intensive Care Units |
| title_full_unstemmed | Mechanical Ventilator-Associated Pneumonia in the COVID-19 Pandemic Era: A Critical Challenge in the Intensive Care Units |
| title_short | Mechanical Ventilator-Associated Pneumonia in the COVID-19 Pandemic Era: A Critical Challenge in the Intensive Care Units |
| title_sort | mechanical ventilator associated pneumonia in the covid 19 pandemic era a critical challenge in the intensive care units |
| topic | mechanical ventilation nosocomial infections viral and bacterial co-infections ventilator-associated pneumonia multidrug-resistance |
| url | https://www.mdpi.com/2079-6382/14/1/28 |
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