title: [Multivariate analysis on the association between acquired multi-drug resistant organism infection and ventilator-associated pneumonia:evidence from a nested case-control study of eight ICUs].
abstract: OBJECTIVE
  The aim of this study was to explore the association between acquired multi-drug resistant organism (MDRO) and ventilator-associated pneumonia (VAP) in patients hospitalized at the intensive care unit(ICU).
  
  
  METHODS
  Real-time monitoring system for hospital infection was used to track VAP patients. The period of study was from January 1, 2013 to December 31, 2013. Both a nested case-control study design and logistic multivariable regression model were performed to explore the association.
  
  
  RESULTS
  A total of 142 VAP cases and 342 non-VAP controls were available in this study. Duration of Hospital stay, ICU stay and mechanical days were statistically significant between the case and the control group (P≤0.001). Compared with MDRO negative patient, the MDRO colonization or infection patients showed an 3.05-time increase on the risk of VAP (adjusted OR = 4.05, 95% CI:2.51-5.46). Remarkably,MDRO-positive patients were significantly associated with increased duration of mechanical ventilation and antimicrobial drug use (P < 0.001).
  
  
  CONCLUSIONS
  MDRO colonized and infection patients would significantly increase the risks of VAP, with prolonged hospitalization and ICU stay. Effective measures should be taken to promote and control patient's safety at the hospital.
authors.affiliation: The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China.
authors.forename: Wensen
authors.initials: W
authors.lastname: Chen
authors.affiliation: The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China.
authors.forename: Songqin
authors.initials: S
authors.lastname: Li
authors.affiliation: The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China.
authors.forename: Suming
authors.initials: S
authors.lastname: Zhang
authors.affiliation: The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China.
authors.forename: Bo
authors.initials: B
authors.lastname: Liu
authors.affiliation: The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China.
authors.forename: Yanhong
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China.
authors.forename: Ping
authors.initials: P
authors.lastname: Xu
authors.affiliation: The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China.
authors.forename: Xiang
authors.initials: X
authors.lastname: Zhang
authors.affiliation: The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China.
authors.forename: Yanbo
authors.initials: Y
authors.lastname: Song
authors.affiliation: The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China. Email: metrischen@126.com.
authors.forename: Weihong
authors.initials: W
authors.lastname: Zhang
mesh_terms: D016022:Case-Control Studies; D002681:China / Q000453:epidemiology; D003428:Cross Infection / Q000382:microbiology*; D024901:Drug Resistance, Multiple, Bacterial; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay / Q000706:statistics & numerical data; D016015:Logistic Models; D015999:Multivariate Analysis; D053717:Pneumonia, Ventilator-Associated / Q000453:epidemiology*; D012121:Respiration, Artificial / Q000706:statistics & numerical data; D013997:Time Factors