Clinical Differences Between Survivors and Non-Survivors of Ventilator-Associated Pneumonia: The Roles of Sulbactam/Ampicillin and Methicillin-Resistant Staphylococcus aureus.

IF 2.9 3区医学 Q2 INFECTIOUS DISEASES

Infection and Drug Resistance Pub Date : 2024-12-27 eCollection Date: 2024-01-01 DOI:10.2147/IDR.S497536

Masafumi Seki, Anna Takimoto, Manabu Inoue, Kazuya Niiyama, Ayumu Masuoka, Futoshi Kotajima

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引用次数: 0

Abstract

Background: Ventilator-associated pneumonia (VAP) is one of the most lethal complications in intensive care unit (ICU) patients. However, critical issues of non-survivors vary and are still unclear in VAP patients.

Methods: The clinical differences between survivors and non-survivors of VAP were retrospectively analyzed in patients hospitalized from April 2023 to March 2024.

Results: Of a total of 42 VAP patients, 22 (52.4%) survived, and 20 died. Survivors were significantly younger (69.1 vs 71.7 years, p < 0.01) and received sulbactam/ampicillin (SAM) as the initial antibiotics, significantly more (45.5% vs 10%, p = 0.006) than non-survivors. The male/female ratio and wards where they were managed were similar in both groups, but methicillin-resistant Staphylococcus aureus (MRSA) was detected significantly more frequently in non-survivors (4/4 = 100%).

Conclusion: These data suggest that VAP patients who survived were younger and received treatment with narrow-spectrum antibiotics, such as SAM. Isolation of MRSA might be critical. These findings could influence antibiotic protocols and ICU management strategies to prevent infection with resistant bacteria to improve the prognosis of patients with VAP.

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呼吸机相关性肺炎存活者和非存活者的临床差异：舒巴坦/氨苄西林和耐甲氧西林金黄色葡萄球菌的作用

背景：呼吸机相关性肺炎（VAP）是重症监护病房（ICU）患者最致命的并发症之一。然而，非幸存者的关键问题各不相同，在VAP患者中仍不清楚。方法：回顾性分析2023年4月至2024年3月住院的VAP患者存活与非存活患者的临床差异。结果：42例VAP患者中，22例（52.4%）存活，20例死亡。幸存者明显更年轻（69.1岁vs 71.7岁，p < 0.01），接受舒巴坦/氨苄西林（SAM）作为初始抗生素，显著多于非幸存者（45.5% vs 10%, p = 0.006）。两组患者的男女比例和病房相似，但在非幸存者中检测到耐甲氧西林金黄色葡萄球菌（MRSA）的频率明显更高（4/4 = 100%）。结论：这些数据表明，存活的VAP患者更年轻，并接受窄谱抗生素治疗，如SAM。MRSA的分离可能是关键。这些发现可能影响抗生素方案和ICU管理策略，以预防耐药菌感染，从而改善VAP患者的预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Infection and Drug Resistance Medicine-Pharmacology (medical)

CiteScore

5.60

自引率

7.70%

发文量

826

审稿时长

16 weeks

期刊介绍： About Journal Editors Peer Reviewers Articles Article Publishing Charges Aims and Scope Call For Papers ISSN: 1178-6973 Editor-in-Chief: Professor Suresh Antony An international, peer-reviewed, open access journal that focuses on the optimal treatment of infection (bacterial, fungal and viral) and the development and institution of preventative strategies to minimize the development and spread of resistance.