Ventilator-Associated Pneumonia (VAP), Microbiological Profile and Antibiotic Resistance Pattern: A Systematic Review

Background: Ventilator-associated pneumonia is one of the most common causes of mortality in intensive care unit patients especially in countries with limited resources. Moreover, the emergence of multi-drug resistance pathogens is an alarming situation for the world healthcare community.This systemic review was designed to find the incidence, microbiological profile, common comorbidities and compare the resistance pattern of the most frequently isolated pathogens in lower-middle-income countries (LMICs), upper-middle-income countries (UMICs), and high-income countries (HICs). Methods: This systematic review was conducted according to the PRISMA guidelines. The extensive literature search with selected MeSH terms was done by using various databases, till August 30, 2021. The information extracted from each study includes baseline characteristics, incidence, microbiological profile, and resistance pattern. Results: In the final analysis we included 29 studies. The overall incidence ranged between 20-49%. The microbiological profile suggested that Gram-negative bacteria was the most frequent including Acinetobacter spp., followed by Pseudomonas spp., and, Klebsiella spp. While 8 studies also reported the Candida spp., and 3 studies reported the Aspergillus. The resistance pattern showed the multi-drug resistance (MDR) of all isolated bacteria with the highest prevalence in LMICs followed by UMICs and HICs. Conclusion: We conclude organisms involved in VAP were highly resistant to commonly used antibiotics. Thus, there is an urgent need for better therapeutic strategies to combat these MDR bugs.