The global epidemiology of ventilator-associated pneumonia caused by multi-drug resistant Pseudomonas aeruginosa: a systematic review and meta-analysis.

Abstract

ObjectiveThe objective of this systematic review and meta-analysis was to estimate the global prevalence of multi-drug resistant (MDR) Pseudomonas aeruginosa causing ventilator-associated pneumonia (VAP). MethodsThe systematic search was conducted in four databases. Original studies describing MDR P. aeruginosa VAP prevalence in adults from 2012 to 2022 were included. Meta-analysis, using the random effects model, was conducted for overall, subgroups (country, published year, study duration, and study design), and European data, respectively. Univariate meta-regression based on pooled estimates was also conducted. Systematic review registered in PROSPERO (CRD42022384035). ResultsThirty-one studies, containing a total of 7,951 cases from 16 countries, were included. The overall pooled prevalence of MDR among P. aeruginosa causing VAP was 33% (95% CI 27.7%-38.3%). The highest prevalence was for Iran 87.5% (95% CI 69%-95.7%), and the lowest was for the USA 19.7% (95% CI 18.6%-20.7%). The European prevalence was 29.9% (95% CI 23.2%-36.7%). ConclusionThis review indicates that the prevalence of MDR P. aeruginosa in VAP patients is generally high and varies significantly between countries, however data are insufficient for many countries. The data in this study can provide a reference for VAP management and drug customisation strategies .