Multivariate analysis on the association between acquired multi-drug resistant organism infection and ventilator-associated pneumonia:evidence from a nested case-control study of eight ICUs

Abstract

The aim of this study was to explore the association between acquired multi-drug resistant organism (MDRO) and ventilator-associated pneumonia (VAP) in patients hospitalized at the intensive care unit(ICU). Real-time monitoring system for hospital infection was used to track VAP patients. The period of study was from January 1, 2013 to December 31, 2013. Both a nested case-control study design and logistic multivariable regression model were performed to explore the association. A total of 142 VAP cases and 342 non-VAP controls were available in this study. Duration of Hospital stay, ICU stay and mechanical days were statistically significant between the case and the control group (P≤0.001). Compared with MDRO negative patient, the MDRO colonization or infection patients showed an 3.05-time increase on the risk of VAP (adjusted OR = 4.05, 95% CI:2.51-5.46). Remarkably,MDRO-positive patients were significantly associated with increased duration of mechanical ventilation and antimicrobial drug use (P < 0.001). MDRO colonized and infection patients would significantly increase the risks of VAP, with prolonged hospitalization and ICU stay. Effective measures should be taken to promote and control patient's safety at the hospital.