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Ventilator-associated pneumonia: Risk factors for multidrug-resistance in adults

Ventilator-associated pneumonia: Risk factors for multidrug-resistance in adults
Risk factors for MDR pathogens:
  • IV antibiotic use within the previous 90 days
  • Septic shock at the time of VAP
  • ARDS preceding VAP
  • ≥5 days of hospitalization prior to the occurrence of VAP
  • Acute renal replacement therapy prior to VAP onset
Risk factors for MDR Pseudomonas and other gram-negative bacilli:
  • Treatment in an ICU in which >10 percent of gram-negative isolates are resistant to an agent being considered for monotherapy
  • Treatment in an ICU in which local antimicrobial susceptibility rates are not known
  • Colonization with OR prior isolation of MDR Pseudomonas or other gram-negative bacilli
Risk factors for MRSA:
  • Treatment in a unit in which >10 to 20 percent of Staphylococcus aureus isolates are methicillin resistant
  • Treatment in a unit in which the prevalence of MRSA is not known
  • Colonization with OR prior isolation of MRSA
MDR: multidrug resistant; IV: intravenous; VAP: ventilator-associated pneumonia; ARDS: acute respiratory distress syndrome; ICU: intensive care unit; MRSA: methicillin-resistant S. aureus.
Adapted from: Kalil AC, Metersky ML, Klompas M, et al. Management of adults with hospital-acquired and ventilator-associated pneumonia: 2016 clinical practice guidelines by the Infectious Diseases Society of America and the American Thoracic Society. Clin Infect Dis 2016; 63:e61.
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