title: The impact of multidrug resistance on outcomes in ventilator-associated pneumonia.
abstract: Multidrug-resistant (MDR) organisms in ventilator-associated pneumonia were found in 49 of 107 patients and were associated with home antibiotics, pre-ventilator-associated pneumonia hospital stay, and health care exposure. Overall, MDR organisms were associated with increased mortality (P = .006). On multivariate analysis, MDR status was modulated by organism class. In nonfermenting gram-negative rods, no association between MDR and mortality was found, but, in all other organisms, MDR was associated with increased mortality risk (hazard ratio, 6.15; 95% confidence interval: 1.80-21.05, P = .004).
authors.affiliation: Department of Infectious Diseases, Medicine Institute, Cleveland Clinic, Cleveland, OH.
authors.forename: Rudy
authors.initials: R
authors.lastname: Tedja
authors.affiliation: Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH.
authors.forename: Amy
authors.initials: A
authors.lastname: Nowacki
authors.affiliation: Department of Infectious Diseases, Medicine Institute, Cleveland Clinic, Cleveland, OH; Department of Infection Prevention, Quality and Patient Safety Institute, Cleveland Clinic Foundation, Cleveland Clinic, Cleveland, OH.
authors.forename: Thomas
authors.initials: T
authors.lastname: Fraser
authors.affiliation: Department of Infection Prevention, Quality and Patient Safety Institute, Cleveland Clinic Foundation, Cleveland Clinic, Cleveland, OH.
authors.forename: Cynthia
authors.initials: C
authors.lastname: Fatica
authors.affiliation: Department of Infection Prevention, Quality and Patient Safety Institute, Cleveland Clinic Foundation, Cleveland Clinic, Cleveland, OH.
authors.forename: Lori
authors.initials: L
authors.lastname: Griffiths
authors.affiliation: Department of Infectious Diseases, Medicine Institute, Cleveland Clinic, Cleveland, OH.
authors.forename: Steven
authors.initials: S
authors.lastname: Gordon
authors.affiliation: Department of Infectious Diseases, Medicine Institute, Cleveland Clinic, Cleveland, OH.
authors.forename: Carlos
authors.initials: C
authors.lastname: Isada
authors.affiliation: Division of Infectious Diseases, University of North Carolina, Chapel Hill, NC. Electronic address: david_vanduin@med.unc.edu.
authors.forename: David
authors.initials: D
authors.lastname: van Duin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001419:Bacteria / Q000187:drug effects* / Q000302:isolation & purification; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D053717:Pneumonia, Ventilator-Associated / Q000188:drug therapy* / Q000382:microbiology / Q000401:mortality; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents
keywords: Hospital-acquired infections; Intensive care units; Multidrug-resistant organisms; Pseudomonas aeruginosa