2023
DOI: 10.1017/ash.2023.470
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Multidrug-resistant VAP before and during the COVID-19 pandemic among hospitalized patients in a tertiary private hospital

Alec Ann Alissa F. Aligui,
Cybele Lara R. Abad

Abstract: Background: There is limited data on ventilator-associated pneumonia (VAP) and multidrug-resistant VAP (MDR VAP) among COVID-19 patients. Methods: A retrospective study in a single, tertiary, private hospital in the Philippines was conducted comparing the incidence, profile, and patient outcomes of MDR VAP during the pre-COVID-19 (2018–2019) and COVID-19 (2020–2021) periods. Results: In total, 80/362 (22%) patients developed VAP, 27/204 (33.75%) from pre-COVID-19 and 53… Show more

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Cited by 2 publications
(3 citation statements)
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“…During the analyzed period, VAP occurred more frequently in the group of patients with pneumonia caused by COVID-19 than in patients without COVID-19 (52/234, 22.1% vs. 180/1506, 11.95%; p = 0.000). This corresponds to the findings of other research where the incidence density of VAP during the COVID-19 period exceeded that of the pre-COVID-19 period (19.3 vs. 27.8 per 1000 VD); however, no statistical significance was found [38].…”
Section: Vap Analysis In Relation To Selected Risk Factorssupporting
confidence: 90%
“…During the analyzed period, VAP occurred more frequently in the group of patients with pneumonia caused by COVID-19 than in patients without COVID-19 (52/234, 22.1% vs. 180/1506, 11.95%; p = 0.000). This corresponds to the findings of other research where the incidence density of VAP during the COVID-19 period exceeded that of the pre-COVID-19 period (19.3 vs. 27.8 per 1000 VD); however, no statistical significance was found [38].…”
Section: Vap Analysis In Relation To Selected Risk Factorssupporting
confidence: 90%
“…Another important fact raised by recent literature is that pathogens causing VAP can vary depending on some other cumulative risk factors, such as length of stay in the ICU, length of hospitalization, previous exposure to antibiotic treatment, local microbial ecology and timing of ventilatory support [ 19 , 20 ]. Precisely, it is generally accepted that early-onset ventilator-associated pneumonia, which occurs within the first 4 days of ventilatory support, is usually caused by non-multidrug resistant (non-MDR) pathogens, which can be found in the common oropharyngeal flora; in comparison, in the late-onset type, which occurs after at least 5 days of ventilatory support, pathogens are commonly multidrug resistant (MDR) [ 8 , 21 ].…”
Section: Relevant Sectionsmentioning
confidence: 99%
“…Conventionally, diagnosing VAP using clinical findings can be challenging due to the non-specific signs and symptoms found in a critically ill patient, this being the reason why authors generally recommend a complex clinical approach. Therefore, most patients suspected of having VAP usually present with the following clinical features after at least 48 h from endotracheal intubation and mechanical ventilation: new and progressive infiltrates on the chest radiography or computed tomography scan, plus at least two of the following features, those being new onset of fever (more than 38 • C), altered value of white blood cell count (leukocytosis > 12.000 cells/mm 3 or leukopenia < 4000 cells/mm 3 ) and the presence of purulent secretions [19]. Some studies also included other clinical findings, such as hypoxemia, tachypnea, hemoptysis, crackles and altered ventilator parameters which increased inspiratory pressures with low tidal volumes [27].…”
Section: Diagnostic Toolsmentioning
confidence: 99%