Work

Microbiological aetiology of paediatric ventilator-associated pneumonia and risk factors for carbapenem-resistant acinetobacter and Pseudomonas in a tertiary-care hospital in Thailand

Year: 2026

Type: article

Abstract: Background Paediatric ventilator-associated pneumonia(VAP) worsens outcomes and mortality. Characterizing local microbiology and resistance patterns is crucial for empirical therapy and guiding targeted infection prevention and control. Objective This study aimed to determine aetiology of VAP, risk factors associated with VAP caused by carbapenem-resistant(CR) Acinetobacter and Pseudomonas , and assess the clinical burden and outcomes of VAP in paediatric patients. Methods We conducted a retrospective study of patients under 18 years diagnosed with VAP between January 2022 and December 2024, utilizing CDC/NHSN surveillance criteria. Data including demographics, microbiology, and outcomes were retrieved from electronic medical records. Risk factors for CR-VAP were assessed using logistic regression. Results A total of 71 VAP patients, 95 episodes, were analysed(median age: 7.1 months(IQR 2-63); 49% male). The VAP incidence rate showed a decreasing trend(9.1 to 4.7 per 1,000 ventilator-days, 2022–2024). The median time to VAP onset was 25 days(IQR 13-51) post-intubation. The predominant isolated pathogens were Gram-negative bacteria, specifically Acinetobacter baumannii (22%; 64% CR), Pseudomonas aeruginosa (19%; 56% CR), and Stenotrophomonas maltophilia (19%). Staphylococcus aureus (8%; 21% MRSA) was the most common Gram-positive isolate. Thirteen patients(18%) experienced multiple VAP episodes. The overall 90-day mortality rate was 24%. Prolonged hospitalization was linked to CRAB(aOR 4.3; 95% CI 1.36–13.61; p=0.013), while prolonged intubation was associated with CRPA(aOR 6.61; 95% CI 1.42–30.85; p=0.016). Conclusion VAP remains a challenge in paediatric setting, characterized by a high prevalence of multidrug-resistant pathogens, particularly CR Acinetobacter and Pseudomonas . Continued surveillance, antimicrobial stewardship, and intensified prevention are essential to reduce VAP burden and improve outcomes.

Source: Infection Prevention in Practice

DOI: 10.1016/j.infpip.2026.100595

Authors: Nicharee Chruakanchana, Napaporn Chantasrisawad, Wirada Horapong, Suvaporn Anugulruengkitt

Institutions: Chulalongkorn University, Thai Red Cross Society, King Chulalongkorn Memorial Hospital

Language: English

Topic: Nosocomial Infections in ICU

Subfield: Critical Care and Intensive Care Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,500