Clinical Differences Between Survivors and Non-Survivors of Ventilator-Associated Pneumonia: The Roles of Sulbactam/Ampicillin and Methicillin-Resistant Staphylococcus aureus

呼吸机相关性肺炎幸存者和非幸存者之间的临床差异:舒巴坦/氨苄西林和耐甲氧西林金黄色葡萄球菌的作用

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Abstract

BACKGROUND: 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. METHODS: The clinical differences between survivors and non-survivors of VAP were retrospectively analyzed in patients hospitalized from April 2023 to March 2024. RESULTS: 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 Staphylococcus aureus (MRSA) was detected significantly more frequently in non-survivors (4/4 = 100%). CONCLUSION: 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.

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