Microbiological aetiology of paediatric ventilator-associated pneumonia and risk factors for carbapenem-resistant acinetobacter and Pseudomonas in a tertiary-care hospital in Thailand.
4 affiliations
- 1Department of Paediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
- 2Thai Red Cross Emerging Infectious Diseases Clinical Centre (TRC-EIDCC), King Chulalongkorn Memorial Hospital the Thai Red Cross Society, Bangkok, Thailand.
- 3Center of Excellence for Paediatric Infectious Diseases and Vaccines, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
- 4Infection Control Unit, Department of Nursing, King Chulalongkorn Memorial Hospital the Thai Red Cross Society, Bangkok, Thailand.
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 the aetiology of VAP, identify 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 of age diagnosed with VAP between January 2022 and December 2024, using Centres for Disease Control and Prevention/National Healthcare Safety Network (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 with 95 episodes, were analysed (median age: 7.1 months [interquartile range {IQR}, 2-63]; 49% male). The VAP incidence rate showed a decreasing trend (9.1 to 4.7 per 1000 ventilator-days, 2022-2024). The median time to VAP onset was 25 days (IQR, 13-51) postintubation. 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% Methicillin-resistant Staphylococcus aureus [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 carbapenem-resistant A. baumannii (CRAB) (adjusted odds ratio [aOR], 4.3; 95% confidence interval [CI], 1.36-13.61; P = 0.013), while prolonged intubation was associated with carbapenem-resistant P. aeruginosa (CRPA) (aOR, 6.61; 95% CI, 1.42-30.85; P = 0.016).Conclusion
VAP remains a challenge in the paediatric setting, characterized by a high prevalence of multi-drug-resistant pathogens, particularly CR Acinetobacter and Pseudomonas. Continued surveillance, antimicrobial stewardship, and intensified prevention are essential to reduce VAP burden and improve outcomes.
Related
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BibTeX
@article{chruakanchana2026microbiological,
title = {{Microbiological aetiology of paediatric ventilator-associated pneumonia and risk factors for carbapenem-resistant acinetobacter and Pseudomonas in a tertiary-care hospital in Thailand.}},
author = {Nicharee Chruakanchana and Napaporn Chantasrisawad and Wirada Horapong and Suvaporn Anugulruengkitt},
journal = {Infection prevention in practice},
year = {2026},
month = sep,
doi = {10.1016/j.infpip.2026.100595},
url = {https://europepmc.org/article/MED/42898844},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Microbiological aetiology of paediatric ventilator-associated pneumonia and risk factors for carbapenem-resistant acinetobacter and Pseudomonas in a tertiary-care hospital in Thailand.
AU - Nicharee Chruakanchana
AU - Napaporn Chantasrisawad
AU - Wirada Horapong
AU - Suvaporn Anugulruengkitt
PY - 2026
DA - 2026/09/19
JO - Infection prevention in practice
DO - 10.1016/j.infpip.2026.100595
UR - https://europepmc.org/article/MED/42898844
AB - 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 the aetiology of VAP, identify 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 of age diagnosed with VAP between January 2022 and December 2024, using Centres for Disease Control and Prevention/National Healthcare Safety Network (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 with 95 episodes, were analysed (median age: 7.1 months [interquartile range {IQR}, 2-63]; 49% male). The VAP incidence rate showed a decreasing trend (9.1 to 4.7 per 1000 ventilator-days, 2022-2024). The median time to VAP onset was 25 days (IQR, 13-51) postintubation. 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% Methicillin-resistant Staphylococcus aureus [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 carbapenem-resistant A. baumannii (CRAB) (adjusted odds ratio [aOR], 4.3; 95% confidence interval [CI], 1.36-13.61; P = 0.013), while prolonged intubation was associated with carbapenem-resistant P. aeruginosa (CRPA) (aOR, 6.61; 95% CI, 1.42-30.85; P = 0.016).Conclusion VAP remains a challenge in the paediatric setting, characterized by a high prevalence of multi-drug-resistant pathogens, particularly CR Acinetobacter and Pseudomonas. Continued surveillance, antimicrobial stewardship, and intensified prevention are essential to reduce VAP burden and improve outcomes.
SN - 2590-0889
ER -