The Relationship Between Renal Functions and Multi Drug Resistant Organisms

Study Overview
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Brief Summary
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Ventilator-associated pneumonia (VAP) is the most common nosocomial infection in patients receiving invasive mechanical ventilation (MV). Antibiotic resistance poses an increasing threat due to the rise of infections caused by multidrug-resistant organisms (MDROs).Despite the increase in the frequency of MDRO colonisation and infection in dialysis patients, it is not known enough whether the risk of multi-drug resistant (MDR) pneumonia increases in mild-to-severe chronic kidney disease (CKD) (eGFR <60 mL/min/1.73 m2) patients not receiving dialysis. Therefore, in our study, the investigators aimed to evaluate the relationship between renal functions and MDR VAP risk and the specific microbial pattern.

Detailed Description
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This prospective observational study was performed on adult patients intubated and receiving MV for at least 48 hours in the 42-bed surgical and medical Intensive Care Unit. The study was conducted between August 2019 and January 2021 and approved by the Ethics Committee of Necmettin Erbakan University Medical School. Informed consents were obtained from patients participating in the study or from their relatives. The characteristics of patients with MDRO infection associated with different eGFR categories in VAP patients were recorded.

Official Title
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The Relationship Between Renal Functions and Multi Drug Resistant Organisms in Patients With Ventilator Associated Pneumonia

Conditions
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Chronic Kidney Disease, Glomerular Filtration Rate, Drug Resistance

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients of 18 years of age and above A clinical suspicion of VAP as defined in the American Thoracic Society (ATS) guidelines A Clinical Pulmonary Infection Score (CPIS) > 6 No signs and symptoms of infection at the time of admission to the ICU Exclusion Criteria: Acute kidney injury Renal replacement treatment (RRT) Dialysis Renal transplantation Active tuberculosis Malnutrition Immunosuppression (neutropenia, HIV positivity, transplantation, prednisone treatment of ≥20 mg/day, etc.) Any extrapulmonary infection other than VAP at the time of being included in the study Respiratory cultures presented fungal agents Normal flora No growth

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| High eGFR group (eGFR ≥60 mL/ min/1.73 m2)<br>Patients with estimated glomerular filtration rate (eGFR) ≥60 mL/ min/1.73 m2 as high eGFR group | |
| Low eGFR group (eGFR <60 mL/min/1.73 m2)<br>Patients with estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2 as low eGFR group | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Multi-drug resistant (MDR) pneumonia | The presence of an infection with a resistant pathogen in patients with impaired renal function (eGFR <60 mL/min/1.73 m2) served as our primary outcome measure | 18 months |