Antibiotic Susceptibility of Ventilator-Associated Pneumonia in Pediatric Intensive Care Unit at Ratchaburi Hospital

Abstract

Background: Healthcare associated infections, expectially ventilator associated pneumonia (VAP) are important public health issue. Antibiotic resistant bacteria are also increased severity and burden that affect high mortality and prolonged hospitalization.
Objective: To study antibiotic susceptibility of VAP in pediatric intensive care unit (PICU) at Ratchaburi hospital.
Methods: A retrospective descriptive study, collected data from medical records of 1 month to 15 years old children were diagnosed VAP at Ratchaburi hospital since October 1, 2019 to September 31, 2022.
Results: There were 37 patients, 21males (56.8%), median age was 50 months (IQR 12 to 97) and 71 episodes of VAP. The major bacterial pathogens were A. baumannii (40.8%), P. aeruginosa (28.2%) and S. maltophilia (16.9%), respectively. The most of A. baumannii isolates were carbapenem-resistant A. baumannii (93.1%) which sensitive to colistin 3.4%. Carbapenem-resistant P. aeruginosa were 45.0% and multidrug-resistant P. aeruginosa were 25.0%. The median (IQR) mechanical ventilator support days were 22 days (14,35) and mortality rate was 21.6%. However mechanical ventilator support days and mortality rate in resistant antibiotic bacteria and non-resistant antibiotic bacteria were not significantly different. The mean±SD mechanical ventilator support days was 26.2± 14.7 days in carbapenem-resistant A. baumannii group vs 21.5± 14.8 days in non- carbapenem-resistant A. baumannii group; p 0.76 and the mortality rate was 22.2% in carbapenem-resistant
A. baumannii group vs 0% in non- carbapenem-resistant A. baumannii group; p 0.62. The
mean±SD mechanical ventilator support days was 32.1±16.1 days in carbapenem-resistant P. aeruginosa group vs 20.8± 8.3 days in non- carbapenem-resistant P. aeruginosa group; p 0.08 and the mortality rate was 0% in carbapenem-resistant P. aeruginosa group vs 9.1% in non- carbapenem-resistant P. aeruginosa group; p 0.09.
Conclusion: High prevalence of antimicrobial resistance rate of pediatric VAP in Ratchaburi hospital, expectially A. baumannii, P. aeruginosa and S. maltophilia. The most of bacteria of pediatric VAP were carbapenem-resistant A. baumannii (CRAB) (38.0%).