P-1066. Microbiological profile of nosocomial pneumonias in the icu of a third level public health center of the dominican republic

TL;DR

This study analyzed the microbiological profile of hospital-acquired pneumonia in a Dominican Republic ICU, finding that Pseudomonas aeruginosa was the most common pathogen.

Contribution

The study provides a local microbiological profile of HAP/VAP and identifies age-related patterns in bacterial isolation.

Findings

Pseudomonas aeruginosa was the most frequently isolated microorganism (15%).

There was a statistical association between age groups and isolated microorganisms (p=0.025).

Septic shock was linked to higher culture positivity, but no growth in cultures did not affect survival.

Abstract

Hospital-acquired pneumonia (HAP) accounts for approximately 22% of all hospital-acquired infections, with an attributable mortality rate reaching up to 33% in critically ill patients.HAP increases length of stay, broad-spectrum antibiotic use, costs, and complications, negatively affecting patient outcomes
Figure 1.Species of microorganism isolated in blood culture and culture of bronchial secretion

Hospital-acquired pneumonia (HAP) accounts for approximately 22% of all hospital-acquired infections, with an attributable mortality rate reaching up to 33% in critically ill patients.

HAP increases length of stay, broad-spectrum antibiotic use, costs, and complications, negatively affecting patient outcomes

Species of microorganism isolated in blood culture and culture of bronchial secretion

A retrospective cross-sectional observational study was conducted to analyze the microbiological profile and clinical outcomes of patients diagnosed with HAP/VAP during the period from July 1, 2023, to July 1, 2024.HAP and VAP were defined using IDSA guideline criteria, with HAP in those hospitalized >48 hours, and VAP >48 hours of mechanical ventilationPatients were required to have at least one culture report from blood or bronchial aspirate obtained via tracheal cannula (MiniBAL).Statistical analysis was performed using the Chi-square test (χ²)and ANOVA for variable cross-analysisFigure 2.Association between group age and bacterial isolation on bornchial culture

HAP and VAP were defined using IDSA guideline criteria, with HAP in those hospitalized >48 hours, and VAP >48 hours of mechanical ventilation

Patients were required to have at least one culture report from blood or bronchial aspirate obtained via tracheal cannula (MiniBAL).

Statistical analysis was performed using the Chi-square test (χ²)and ANOVA for variable cross-analysis

Association between group age and bacterial isolation on bornchial culture

Of a total of 270 records analyzed, only 60 patients met the inclusion criteria, of which 42 (70%) were male;The average age was 44.5 +/- 18.42 years, with the range of 18-29 being the most frequent (30%). 60% of the patients had an associated co-morbidity, HTN (30%) followed by DM (23.3%), were the most frequent.The average LOS was 22.5 (+/- 9.46) days, where 91.7% of patients were ventilatedRegarding cultures, 63.3% reported no growth, with P. auriginosa being the most frequent (15%), followed by E. coli (6.7%) and A. baumanii (5%). (Figure 1), we found a statistical relationship between the age groups and the isolated microorganism (p=0.025).During septic shock events, microorganisms were isolated more frequently, with P. auriginosa and E. Coli being the most frequent, in 7 and 3 cases, respectively, we did not find a difference between survival and cultures reported without growth (P value 0.334). (Figure 2)

The average age was 44.5 +/- 18.42 years, with the range of 18-29 being the most frequent (30%). 60% of the patients had an associated co-morbidity, HTN (30%) followed by DM (23.3%), were the most frequent.

The average LOS was 22.5 (+/- 9.46) days, where 91.7% of patients were ventilated

Regarding cultures, 63.3% reported no growth, with P. auriginosa being the most frequent (15%), followed by E. coli (6.7%) and A. baumanii (5%). (Figure 1), we found a statistical relationship between the age groups and the isolated microorganism (p=0.025).

During septic shock events, microorganisms were isolated more frequently, with P. auriginosa and E. Coli being the most frequent, in 7 and 3 cases, respectively, we did not find a difference between survival and cultures reported without growth (P value 0.334). (Figure 2)

In this study, lack of culture growth was not associated with better survivalCritical illness with Septic shock had higher likelihood of culture positivityThese findings reinforce the importance of monitoring specific complications according to age groups and the identified microorganism to improve clinical outcomes.

Critical illness with Septic shock had higher likelihood of culture positivity

These findings reinforce the importance of monitoring specific complications according to age groups and the identified microorganism to improve clinical outcomes.

All Authors: No reported disclosures

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