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J Pediatr Intensive Care
DOI: 10.1055/s-0043-1772818
Original Article

Ventilator-Associated Pneumonia Caused by Carbapenem-Resistant Gram-Negative Bacteria in a Pediatric Intensive Care Unit

Melis Deniz 
1   Department of Pediatric Infectious Diseases, Sanlıurfa Training and Research Hospital, Sanlıurfa, Türkiye
,
Hande Şenol
2   Department of Bioistatistics, Pamukkale University, Denizli, Türkiye
,
Tugba Erat
3   Department of Pediatric Infectious Diseases, Ankara City Hospital, Ankara, Türkiye
,
Hatice Feray Arı
4   Department of Pediatric Intensive Care Unit, Sanlıurfa Training and Research Hospital, Sanlıurfa, Türkiye
,
Ümit Altug
5   Department of Pediatric Intensive Care Unit, Pamukkale University, Denizli, Türkiye
,
Eylem Kıral
6   Department of Pediatric Intensive Care Unit, Osmangazi University, Eskişehir, Türkiye
,
Kerim Parlak
7   Department of Microbiology, Sanlıurfa Training and Research Hospital, Sanlıurfa, Türkiye
,
Hadice Özçınar
7   Department of Microbiology, Sanlıurfa Training and Research Hospital, Sanlıurfa, Türkiye
› Institutsangaben Funding None.
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Abstract

We aimed to analyze risk factors of ventilator-associated pneumonia (VAP) caused by multidrug-resistant (MDR), pan-drug-resistant (PDR), and extensively drug-resistant (XDR) gram-negative bacteria (GNB) in a pediatric intensive care unit (PICU). This retrospective study evaluated pediatric patients diagnosed with VAP at a tertiary referral hospital. Of the 46 children in the present study, 40 (86.9%) had VAP caused by MDR-, XDR-, and PDR-GNB. Most patients (60.9%) had spent >28 days in the PICU at the time of diagnosis. Respiratory failure necessitating PICU admission was associated with XDR infection-induced VAP (p = 0.034). High rates of prior broad-spectrum antibiotic use were observed in patients with XDR GNB-induced VAP. VAP induced by MDR-, XDR-, and PDR-GNB occurred more frequently than that caused by drug-susceptible GNB in PICU patients. Long stays for more than 28 days in the PICU and past use of broad-spectrum antibiotics can lead to the development of XDR-GNB-induced VAP. The high antibiotic resistance rates detected in our study highlight the importance of strict infection control measures and antimicrobial stewardship programs in PICUs.

Keywords

ventilator-associated pneumonia - pediatric intensive care unit - antibiotic resistance - antimicrobial stewardship - carbapenem-resistant


Publikationsverlauf

Eingereicht: 06. Mai 2023

Angenommen: 25. Juli 2023

Artikel online veröffentlicht:
28. August 2023

© 2023. Thieme. All rights reserved.

Georg Thieme Verlag KG
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