Seki Masafumi, Takimoto Anna, Inoue Manabu, Niiyama Kazuya, Masuoka Ayumu, Kotajima Futoshi
Division of Infectious Diseases and Infection Control, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan.
Respiratory Support Team, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan.
Infect Drug Resist. 2024 Dec 27;17:5875-5879. doi: 10.2147/IDR.S497536. eCollection 2024.
Ventilator-associated pneumonia (VAP) is one of the most lethal complications in intensive care unit (ICU) patients. However, critical issues of non-survivors vary and are still unclear in VAP patients.
The clinical differences between survivors and non-survivors of VAP were retrospectively analyzed in patients hospitalized from April 2023 to March 2024.
Of a total of 42 VAP patients, 22 (52.4%) survived, and 20 died. Survivors were significantly younger (69.1 vs 71.7 years, p < 0.01) and received sulbactam/ampicillin (SAM) as the initial antibiotics, significantly more (45.5% vs 10%, p = 0.006) than non-survivors. The male/female ratio and wards where they were managed were similar in both groups, but methicillin-resistant (MRSA) was detected significantly more frequently in non-survivors (4/4 = 100%).
These data suggest that VAP patients who survived were younger and received treatment with narrow-spectrum antibiotics, such as SAM. Isolation of MRSA might be critical. These findings could influence antibiotic protocols and ICU management strategies to prevent infection with resistant bacteria to improve the prognosis of patients with VAP.
呼吸机相关性肺炎（VAP）是重症监护病房（ICU）患者中最致命的并发症之一。然而，VAP患者中死亡患者的关键问题各不相同且仍不明确。
回顾性分析2023年4月至2024年3月住院的VAP患者中存活者与死亡者之间的临床差异。
在总共42例VAP患者中，22例（52.4%）存活，20例死亡。存活者明显更年轻（69.1岁对71.7岁，p<0.01），并且作为初始抗生素接受舒巴坦/氨苄西林（SAM）治疗的比例明显高于死亡者（45.5%对10%，p = 0.006）。两组的男女比例以及接受治疗的病房相似，但死亡者中耐甲氧西林金黄色葡萄球菌（MRSA）的检出率明显更高（4/4 = 100%）。
这些数据表明，存活的VAP患者更年轻，并且接受了窄谱抗生素如SAM的治疗。MRSA的分离可能至关重要。这些发现可能会影响抗生素使用方案和ICU管理策略，以预防耐药菌感染，从而改善VAP患者的预后。
