Abstract

Dayane Otero Rodrigues*, Renata Cristina Cezário, and Paulo P. Gontijo Filho

This study aims at investigating whether the development of Ventilator-Associated Pneumonia (VAP) episodes caused by Multidrug-Resistant (MDR) Pseudomonas aeruginosa or other microorganisms (Staphylococcus aureus and other bacilli) were related to different risk factors. A 1-year retrospective case-control study was conducted in surgical-clinical Intensive Care Unit (ICU). Inclusion criteria were VAP cases (n = 66) caused by MDR P. aeruginosa (Group P, n = 31) compared with those caused by other microorganisms (Group C, n = 35). Altogether, the VAP incidence rate of 21.11 per 1, 000 ventilation days was high and compatible with ICUs in developing countries. Most of VAP cases (92.4%) were identified as late-onset pneumonia with 5 early-onset cases associated with MethicillinSusceptible Staphylococcus aureus (MSSA). In a logistic regression analysis, Group P was independently associated with four variables: presence of three or more invasive devices; use of three or more antibiotics; use of aminoglycosides; and absence of immunocompromise. Empirical antibiotic therapy was inadequate in 48.4% of the VAP cases caused by MDR P. aeruginosa with crude mortality rate (46.7%) higher than in those which patients received adequate antibiotics (18.7%). The findings to show that there were no outcome differences between the groups regarding critical care unit survival, but there were significant differences between pathogens groups regarding risk factors.