The relationship between renal functions and multi-drug resistant organisms in patients with ventilator-associated pneumonia

Abstract

Objective: Despite the increase in the frequency of multi-drug resistant organism (MDRO) colonisation and infection in dialysis patients, it is not well known whether the risk of multi-drug resistant (MDR) pneumonia increases in mild-to-severe chronic kidney disease patients not undergoing dialysis. Therefore, we aimed to evaluate the relationship between renal functions and the risk of MDR ventilator-associated pneumonia (VAP) and the specific microbial pattern. Patients and Methods: A total of 133 patients who developed VAP were divided according to their renal function into two groups, an estimated glomerular filtration rate of (eGFR) ≥ 60 mL/ min/1.73 m2 (high eGFR, n=65) and eGFR < 60 mL/min/1.73 m2 (low eGFR, n=68). Results: The low eGFR group presented a significantly high MDRO ratio (p<0.01). With the decrease in eGFR, the frequency of grampositive MDRO did not change (p=0.63), while the increase in gram-negative MDRO was statistically significant (p<0.01). Low eGFR was found to be an independent predictor for antimicrobial resistance. (Odds ratio, (OR): 2.821). Conclusion: Among VAP patients, chronic renal failure is associated with increased MDRO infection. The eGFR may be used to identify mechanically ventilated patients with a high risk of MDR pneumonia.

Keywords

• Chronic kidney disease
• Glomerular filtration rate
• Multiple drug resistance
• Risk factors
• Ventilator-associated pneumonia

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