Factors Predicting Ventilator-Associated Pneumonia Caused by Multidrug Resistant Organisms in Critically Ill Patients
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Abstract
Critically ill patients often have life-threatening illnesses and are prone to organ failure, particularly respiratory failure, which requires intubation and ventilator support. This case-control study was conducted to identify factors predicting ventilator-associated pneumonia caused by multidrug-resistant organisms (VAP-MDR) in intensive care units of a secondary care-level hospital. The subjects were 328 intubated critically ill patients admitted between October 2016 and September 2022. The sample consisted of 164 cases with VAP-MDR and 164 controls without. Data were collected from medical records using a data collection form that assessed demographic information, patient-related risk factors, treatment-related risk factors, and sputum culture results with antimicrobial susceptibility. Descriptive statistics were used to summarize demographic information and risk factor characteristics, while logistic regression analysis was used to identify factors predicting VAP-MDR. The results revealed that the patient-related predictor of VAP-MDR was the APACHE II score (ORadj=1.06, 95%CI=1.02-1.11, p=.006). Treatment-related predictors of VAP-MDR included ventilator days of 7 or more (ORadj=3.63, 95%CI=2.24-5.89, p<.001) and reintubation (ORadj=2.02, 95%CI=1.18-3.45, p=.010). Therefore, to prevent the occurrence of VAP-MDR, measures should be implemented to reduce ventilator days, prevent reintubation, and consider using non-invasive ventilation when appropriate.
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บทความและรายงานวิจัยในวารสารพยาบาลกระทรวงสาธารณสุข เป็นความคิดเห็นของ ผู้เขียน มิใช่ของคณะผู้จัดทำ และมิใช่ความรับผิดชอบของสมาคมศิษย์เก่าพยาบาลกระทรวงสาธารณสุข ซึ่งสามารถนำไปอ้างอิงได้
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