Impact of meticillin-resistance on the mortality in S. aureus VAP: a systematic review
Abstract number: R2334
Athanassa Z., Siempos I., Falagas M.
Objective: To estimate the impact of meticillin-resistance on mortality in ventilator-associated pneumonia (VAP) due to Staphylococcus aureus (SA).
Methods: PubMed, Scopus and bibliographies of the eligible studies were searched. We calculated pooled odds ratio (OR) and 95% confidence intervals (CI) by using the DerSimonian-Laird random effects model.
Results: Eight articles were included. Crude in-hospital mortality was higher in patients with VAP due to meticillin-resistant SA (MRSA) than meticillin-sensitive SA (MSSA) (OR: 1.79, 95% CI 1.212.65). This was also the case for the crude intensive care unit (ICU)-mortality (OR: 2.49, 95% CI 1.544.06). However, 3 of the selected studies, which adjusted for potential confounding factors, including adequacy of empirical treatment and severity of illness, demonstrated no difference in in-hospital mortality between patients with MRSA and MSSA VAP. This was not the case for another eligible study that also adjusted, but for confounders others than the above.
Conclusion: The limited available evidence seems to suggest that meticillin-resistance is associated with death among persons acquiring SA VAP. However, although supported by even more limited data, adjustment of risk factors suggests that this association may be not causal, but likely due to confounders, such as the adequacy of empirical treatment and severity of illness.
|Session name:||18th European Congress of Clinical Microbiology and Infectious Diseases|
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