Exploring Ventilator-Associated Pneumonia: Microbial Clues and Biomarker Insights from a Retrospective Study

Author:

Gouda Ahmed M.1ORCID,Sileem Ashraf E.2ORCID,Elnahas Hanan M.3ORCID,Tawfik Ahmed E.4,Eid Refaat A.5ORCID,Shati Ayed A.6ORCID,Al-Qahtani Saleh M.6,Dawood Samy A.6ORCID,Alshehri Mohammed A.6ORCID,Eissa Mohamed57,Soltan Mohamed A.8ORCID,Noreldin Ahmed E.9ORCID,Elwishahy Amir Helmy10,Negm Essamedin M.11ORCID

Affiliation:

1. Department of Pharmacy Practice, Faculty of Pharmacy, Zagazig University, Zagazig 44519, Egypt

2. Department of Chest Diseases, Faculty of Medicine, Zagazig University, Zagazig 44519, Egypt

3. Department of Pharmaceutical and Industrial Pharmacy, Faculty of Pharmacy, Zagazig University, Zagazig 44519, Egypt

4. Zagazig University Hospitals, Zagazig 44519, Egypt

5. Pathology Department, College of Medicine, King Khalid University, Abha 62529, Saudi Arabia

6. Department of Child Health, College of Medicine, King Khalid University, Abha 62529, Saudi Arabia

7. Clinical Pathology Department, Faculty of Medicine, Zagazig University, Zagazig 44519, Egypt

8. Department of Microbiology and Immunology, Faculty of Pharmacy, Sinai University, Ismailia 41611, Egypt

9. Department of Histology and Cytology, Faculty of Veterinary Medicine, Damanhour University, Damanhour 22511, Egypt

10. General and Onco Surgery Department, Dhahran Aljanoub General Hospital, Aseer 7363, Saudi Arabia

11. Department of Anaesthesia, ICU and Pain Management, Faculty of Medicine, Zagazig University, Zagazig 44519, Egypt

Abstract

Background and Objectives: Ventilator-associated pneumonia (VAP) is a common complication in critically ill patients receiving mechanical ventilation. The incidence rates of VAP vary, and it poses significant challenges due to microbial resistance and the potential for adverse outcomes. This study aims to explore the microbial profile of VAP and evaluate the utility of biomarkers and illness severity scores in predicting survival. Materials and Methods: A retrospective cohort study was conducted involving 130 patients diagnosed with VAP. Microbial analysis of bronchoalveolar lavage (BAL) fluid, as well as measurements of C-reactive protein (CRP) and procalcitonin (PCT) levels, were performed. Sequential Organ Failure Assessment (SOFA) and Acute Physiology and Chronic Health Evaluation II (APACHE II) scores were calculated to assess illness severity. Statistical analyses were conducted to determine correlations and associations. Results: The study revealed that Klebsiella pneumoniae (K. pneumoniae) (50.7%) and Pseudomonas aeruginosa (P. aeruginosa) (27.69%) were the most identified microorganisms in VAP cases. SOFA (p-value < 0.0001) and APACHE II (p-value < 0.0001) scores were effective in assessing the severity of illness and predicting mortality in VAP patients. Additionally, our investigation highlighted the prognostic potential of CRP levels (odds ratio [OR]: 0.980, 95% confidence interval [CI] 0.968 to 0.992, p = 0.001). Elevated levels of CRP were associated with reduced survival probabilities in VAP patients. Conclusion: This study highlights the microbial profile of VAP and the importance of biomarkers and illness severity scores in predicting survival. Conclusions: The findings emphasize the need for appropriate management strategies to combat microbial resistance and improve outcomes in VAP patients.

Funder

Deanship of Research and Graduate Studies at King Khalid University

Publisher

MDPI AG

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