(594) Prevalence of Antibiotic Resistance in ICU Patients With Ventilator-Associated Pneumonia

Introduction: Antibiotic resistance is a critical challenge in healthcare, exacerbated by the overuse of antibiotics and bacterial adaptation. In the ICU, particularly among patients on mechanical ventilation, identifying antibiotics with elevated resistance rates is essential. Such insights can improve antibiotic stewardship programs, refine infection control practices, and update empirical treatment guidelines for more effective patient management.

Methods: A retrospective cohort study was conducted utilizing the Medical Information Mart for Intensive Care III (MIMIC-III) database, encompassing clinical data from ICU patients from 2001 to 2012. We included adult patients aged 20 years and older, both male and female, who were undergoing invasive mechanical ventilation and diagnosed with ventilator-associated pneumonia (VAP) per ICD-9 criteria. The microbiological cultures taken into account were those of respiratory samples obtained by endotracheal aspirates or bronchoalveolar lavage. We looked for the most frequent bacteria in patients admitted to the ICU with ventilator-associated pneumonia and cross-tabulated them with all antibiotics to determine which ones were resistant.
Data analysis was performed with IBM SPSS Statistics version 24.0, utilizing descriptive statistics and Chi-square tests to assess statistical significance.

Results: The study included 271 participants, with a mean age of 55 (3.3% missing). Of these, 151 (55.7%) were female and 120 (44.3%) were male. Our findings revealed that Staphylococcus aureus exhibited a high resistance rate of 48.7% (p < 0.001). Additionally, patients aged 63 years and older had a higher likelihood of antibiotic resistance (p < 0.001), and male patients showed more resistance compared to females (p = 0.019). Bacteria were most resistant to gentamycin (8.5%).

Conclusions: This study highlights the significant issue of antibiotic resistance among ICU patients with ventilator-associated pneumonia. The prevalence of resistance in Staphylococcus aureus, particularly among older and male patients, underscores the urgent need for targeted antibiotic stewardship and age-specific treatment strategies to mitigate resistance and improve patient outcomes.