Assessment of Antibiotic Resistance Patterns and Microbial Profile in Patients with Ventilator-Associated Pneumonia (VAP) Before and After COVID-19 in Intensive Care Unit Patients: A Retrospective Descriptive Study

Authors
Hamed Mehdinejad Gorji Hamed Mehdinejad Gorji 1
sajad yaghoubi 2
Mohammad Eesanezhad Mohammad Eesanezhad 1
Mustafa Javanian Mustafa Javanian 1
Parviz Amri Male Parviz Amri Male 3
Hoda Shirafkan Hoda Shirafkan 3
Mehrdad Halaji Renani 4
abazar pournajaf 3
1 Student Research Committee, Babol University of Medical Sciences, Babol, I.R. Iran
2 medical uni neishapour
3 4- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, I.R. Iran
4 4. Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, I.R. Iran
Abstract
Introduction: Ventilator-associated pneumonia (VAP) is a significant healthcare-associated infection, particularly in intensive care units (ICUs). Given the importance of identifying the microbial profile in hospital wards, especially ICUs during the COVID-19 era, and the need to assess antibiotic resistance patterns, this study aimed to evaluate the antibiotic resistance patterns and microbial profiles in patients with VAP before and after the COVID-19 pandemic.

Methods: This retrospective descriptive-analytical study included patients diagnosed with VAP based on inclusion and exclusion criteria. Demographic data, culture results from endotracheal aspirates and antibiotic susceptibility test results were collected. Data were analyzed using SPSS V.22.

Results: A total of 400 patients were included in the study, with an age range of 38–86 years and a mean age of 59.82 ± 12.39 years. Acinetobacter baumannii was the most commonly isolated pathogen from endotracheal aspirates in both groups (P value < 0.001). The antibiotic resistance analysis revealed that isolates from oral intubation showed higher resistance than those from tracheostomy. Additionally, antibiotic resistance increased significantly after COVID-19 compared to the pre-pandemic period. The susceptibility analysis showed that three antibiotics—amikacin, ceftriaxone, and clindamycin—demonstrated a significant decrease in sensitivity in the post-COVID-19 period.

Conclusion: This study demonstrated that Acinetobacter baumannii was the predominant pathogen in VAP patients, and resistance to amikacin, ceftriaxone, and clindamycin increased post-COVID-19, highlighting the rising challenge of antibiotic resistance in critically ill patients.
Keywords
Antibiotic resistance
Intensive Care Unit
Microbial Profile
Ventilator-Associated Pneumonia
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