Abstract
Staphylococcus aureus (S. aureus) is a common Ventilator-Associated Pneumonia (VAP) isolate. The objective here is to define the extent and possible reasons for geographic variation in the incidences of S. aureus-associated VAP, MRSA-VAP and overall VAP. A meta-regression model of S. aureus-associated VAP incidence per 1000 Mechanical Ventilation Days (MVD) was undertaken using random effects methods among publications obtained from a search of the English language literature. This model incorporated group level factors such as admission to a trauma ICU, year of publication and use of bronchoscopic sampling towards VAP diagnosis. The search identified 133 publications from seven worldwide regions published over three decades. The summary S. aureus-associated VAP incidence was 4.5 (3.9–5.3) per 1000 MVD. The highest S. aureus-associated VAP incidence is amongst reports from the Mediterranean (mean; 95% confidence interval; 6.1; 4.1–8.5) versus that from Asian ICUs (2.1; 1.5–3.0). The incidence of S. aureus-associated VAP varies by up to three-fold (for the lowest versus highest incidence) among seven geographic regions worldwide, whereas the incidence of VAP varies by less than two-fold. Admission to a trauma unit is the most important group level correlate for S. aureus-associated VAP.
Highlights
Ventilator-Associated Pneumonia (VAP) in association with Staphylococcus aureus has been reported from over 100 intensive care units (ICU) worldwide [1–133]
There may be a specific mortality risk for ventilator-associated pneumonia in association with S. aureus infections in the ICU, this may be influenced by associated resistance to methicillin [136,137]
The study inclusion criteria were as follows; a listing of S. aureus among the VAP isolates, reporting in the English language and reports for which a VAP incidence could be estimated using the number of Mechanical Ventilation Days (MVD) as the denominator
Summary
Ventilator-Associated Pneumonia (VAP) in association with Staphylococcus aureus has been reported from over 100 intensive care units (ICU) worldwide [1–133]. In two series drawn predominantly from ICUs in The United States of America and Europe, S. aureus accounted for 20% [134] and 22% [135] of bronchoscopically-documented cases of VAP. Whether VAP is associated with an increase in attributable mortality may depend on the infecting organism [8,12,115,135]. There may be a specific mortality risk for ventilator-associated pneumonia in association with S. aureus infections in the ICU, this may be influenced by associated resistance to methicillin [136,137]. There is a worldwide variation in the microbial aetiologies of VAP and other ICU-acquired infections [1–6,8,115,130–140]. The incidence of Acinetobacter-associated VAP varies five-fold among reports from ICUs from various geographic regions around the world [139]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
