Risk Factors for Multidrug-Resistant Pathogens in Pneumonia

Multidrug-resistant pathogens were present in 59.8% of episodes; the most common being Pseudomonas aeruginosa.
Multidrug-resistant pathogens were present in 59.8% of episodes; the most common being Pseudomonas aeruginosa.
This article is part of MPR's coverage of CHEST 2018 meeting, taking place in San Antonio, TX. Our on-site staff will be reporting on the latest breaking research and clinical advances in infectious diseases. Check back regularly for highlights from CHEST 2018 meeting.

SAN ANTONIO — Previous antibiotic use and intensive care unit mechanical invasive ventilation were risk factors for multidrug-resistant pathogens in patients with either hospital-associated pneumonia or ventilator-associated pneumonia, according to a study presented at the CHEST Annual Meeting October 6 through October10, 2018, in San Antonio, Texas.

Alizamin Sadigov, MD, FCCP, conducted the retrospective study, analyzing patients with pneumonia at the Hospital Clinic of the Medical University of Baku for multidrug-resistant pathogens. Data on sputum and tracheobronchial aspiration, blood cultures, comorbidities, and mortality, was documented.

Of the 132 patients included, 74 were men (mean age, 62.2 years), and 89 had hospital-associated pneumonia. Multidrug-resistant pathogens were present in 59.8% of episodes, with the most common being Pseudomonas aeruginosa (40.5%). Patients with hospital-associated pneumonia were more likely to have Pseudomonas aeruginosa (22.5%), while patients with ventilator-associated pneumonia were more likely to have Acinetobacter baumannii (37.2%).

Previous antibiotic use (78.2%), intensive care unit admission and mechanical invasive ventilation (55.6%), chronic obstructive pulmonary disease (40.5%), bronchiectasis (30.4%), >7 days of hospitalization (29.1%), antacid medication use (26.6%), and bronchoscopy (17.7%) were the prevalent risk factors for multidrug-resistant pathogens.

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Combination drug therapy for the pathogens reduced hospital stays, including intensive cares stays (odds ratio 3.56; 95% CI, 1.77-6.43), and death from pneumonia (odds ratio 2.52; 95% CI, 1.00-4.22). Overall, the mortality rate of patients with ventilator-associated pneumonia was higher at 46.5% than in patients with hospital-associated pneumonia at 29.2% (P=.05).

Dr Sadigov concluded that the 2 highest risk factors for multidrug-resistant pathogens in patients with either hospital-associated pneumonia or ventilator-associated pneumonia were previous antibiotic use and intensive care unit admission with mechanical invasive ventilation. Treatment using “[c]ombined antibiotic therapy may reduce the risk [for multidrug-resistant] pathogens in such patients.”

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Reference

Sadigov A. Risk factors for multidrug-resistant pathogens in hospital-associated and ventilator-associated pneumonia: combined therapy is helpful for treatment? Presented at: CHEST Annual Meeting 2018; October 6-10, 2018; San Antonio, TX.