Risk Factors for 7-Day and 21-Day Mortality in Patients with Ventilator-Associated Pneumonia Caused by Gram-Negative Multidrug Resistant Bacteria

Objective: Incidence of ventilator-associated pneumonia, caused by gram-negative multidrug resistant bacteria, is on the increase and early mortality rate high.
 We aimed to investigate effects aging, comorbidities, high Charlson comobidity index score, Acute Physiology Chronic Health Evaluation II leukocytosis, C-reactive protein level, inappropriate empirical antibiotic therapy resistance in pneumonia multidrug-resistant bacteria.
 Methods: The study was planned as a retrospective cohort study. Patients aged 18 years older who were hospitalized between January 01, 2015, 2020, diagnosed with had Gram-negative pathogen detected blood and/or bronchoalveolar lavage fluid specimen or quantitative endotracheal aspirate cultures included study.
 Results: A total 370 patients Median age 74 (19-95) years. Most frequent bacteria Acinetobacter baumannii (52.4%). Resistance ceftriaxone, meropenem, colistin 99%, 68%, 4%, respectively. 7-day 21-day rates 38.3% (n=142) 85.1% (n=315). In multivariate analysis, associated comorbidity score ≥4, risk factors for septic shock, amikacin resistance, white cell count ≥15000/mm3. Advanced found be factor mortality, mortality. It that tracheostomy lower than without tracheostomy.
 Conclusion:Consideration clinical scoring systems, closer monitoring elderly patients, following-up tracheostomy, may provide decrease pathogens.