Ventilator-associated pneumonia in patients with cancer: Impact of multidrug resistant bacteria
作者机构：Infectious Diseases DepartmentInstituto Nacional de Cancerología(INCan)Mexico City 14080Mexico
出 版 物：《World Journal of Critical Care Medicine》 (世界重症医学杂志)
年 卷 期：2020年第9卷第3期
页 面：43-53页
学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 100214[医学-肿瘤学] 10[医学]
主 题：Ventilator-associated pneumonia Cancer Multidrug resistance bacteria Mortality Intensive care unit Mechanical ventilation
摘 要：BACKGROUND Patients with cancer have several risk factors for developing respiratory failure requiring mechanical ventilation(MV).The emergence of multidrug resistant bacteria(MDRB)has become a public health problem,creating a new burden on medical care in hospitals,particularly for patients admitted to the intensive care unit(ICU).AIM To describe risk factors for ventilator-acquired pneumonia(VAP)in patients with cancer and to evaluate the impact of *** A retrospective study was performed from January 2016 to December 2018 at a cancer referral center in Mexico City,which included all patients who were admitted to the ICU and required MV≥48 *** were classified as those who developed VAP versus those who did not;pathogens isolated,including *** evolution at 60-d was *** analysis was carried out;comparison was performed between VAP vs non-VAP and MDRB vs *** Two hundred sixty-three patients were included in the study;mean age was 51.9 years;52.1%were male;68.4%had solid *** were 32 episodes of VAP with a rate of 12.2%;11.5 episodes/1000 *** most frequent bacteria isolated were the following:Klebsiella spp.[n=9,four were Extended-Spectrum Beta-Lactamase(ESBL)producers,one was Carbapenem-resistant(CR)];Escherichia coli(n=5,one was ESBL),and Pseudomonas aeruginosa(n=8,two were CR).One Methicillin-susceptible Staphylococcus aureus was *** multivariate analysis,the sole risk factor associated for VAP was length of ICU stay(OR=1.1;95%CI:1.03-1.17;P=0.003).Sixty-day mortality was 53%in VAP and 43%without VAP(P=0.342).There was not higher mortality in those patients with *** This study highlights the high percentage of Gram-negative bacteria,which allows the initiation of empiric antibiotic coverage for these *** this retrospective,single center,observational study,MDRB VAP was not directly linked to increased mortality at 60 days.
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