The Relationship Between Renal Functions and Multi Drug Resistant Organisms

Konya Numune Hospital

Status: Completed

Conditions: Chronic Kidney Disease; Glomerular Filtration Rate; Drug Resistance

Study type: Observational

Funder types: Other

Identifiers

NCT04833231

omurilban1

Details and patient eligibility

About

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.

Full description

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.

Enrollment: 133 patients

Sex: All

Ages: 18 to 85 years old

Volunteers: No Healthy Volunteers

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

Trial design

133 participants in 2 patient groups

High eGFR group (eGFR ≥60 mL/ min/1.73 m2)

Description:

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)

Description:

Patients with estimated glomerular filtration rate (eGFR) \<60 mL/min/1.73 m2 as low eGFR group