What question did this study set out to answer?

The research aims to identify risk factors associated with polymicrobial pneumonia and its impact on outcomes in intubated adults with VAP.

May 20, 2026

C54-27 Risk Factors and Outcomes Associated With Polymicrobial Infection in Ventilator-Associated Pneumonia

Key Points

The research aims to identify risk factors associated with polymicrobial pneumonia and its impact on outcomes in intubated adults with VAP.
Retrospective analysis of prospectively collected data from 118 intubated adult patients with VAP.
Assessment of clinical characteristics, microbial etiology, and outcomes, focusing on polymicrobial infections.
Multivariate analysis to identify independent risk factors for polymicrobial aetiology and in-hospital mortality.
Polymicrobial infection was found in 38 (32%) of VAP patients with defined microbial etiology.
Multilobar pneumonia, ARDS, and high comorbidity index emerged as independent risk factors for polymicrobial aetiology (p<0.01).
Polymicrobial infection was an independent predictor of in-hospital mortality with an odds ratio of 2.48 (95% CI 1.00-3.98; p=0.004).

Abstract

Abstract Background Polymicrobial pneumonia is aconcern for clinicians due to its association with increased disease poor outcomes. Evaluation and idenfying patients who have an increased risk of polymicrobial aetiology is important for the management of VAP patients. Objective We have described the clinical characteristics and outcomes of adult intubated patients with VAP, and identify the risk factors related to polymicrobial pneumonia and specifically to in-hospital mortality. Methods Our study was retrospective from a prospectively collected data including 118 intubated adult patients with VAP;91 (77. 0%) patients had an established aetiology. Results Polymicrobial infection was present in 38 (32%) of the VAP patients with defined micribial aetiology. The most frequent polymicrobial infections were: Klebsiella pneumoniae + Staphylococcus aureus (32%), Acinotebacter baumannii +Eschericia coli (21%), S. pneumoniae +Pseudomonas aeruginosa (18%), P. aeruginosa +S. aureus (15. 0%), and S. aureus+E. coli (13. 0%). The age of patients with polymicrobial VAP was hgiher (p 0. 01), comorbidity index also was higher compared to monomicrobial VAP (2. 450. 58-5. 86;p0. 003) and common comorbidities were: DM (37. 0%), COPD (31. 0%), bronchiectasis (26. 0%), and chronic kidney failure (16. 0%). MDR pathogens were common in polymicrobial VAP patients compared to monomicrobial patients (2. 640. 72-5. 22;p0. 01). Polymicrobial infection was frequent in patients with late -onset VAP (3. 440. 94-7. 44;p0. 001). Septic shock and bacteremia was common founded in polymicrobial VAP (2. 680. 72-5. 32;p0. 004) and ARDS was common complications in polymicrobial VAP (4. 22098-8. 58;p0. 001). Length of ICU stay was higher in polymicrobial VAP patients (p 0. 0010 and duration of mechanical ventilation days was hgiher in polymicrobial VAP patients (12+₄ days vs 16+₅ days ;p0. 001). Multilobar pneumonia (2. 341. 00-4. 22;p0. 01), ARDS (2. 920. 94-5. 32;p0. 004) and hgih comorbidity index (2. 580. 82-4. 90;p0. 005) were an idependent risk factors for polymicrobial aetiology in the multivariate analysis. Polymicrobial infection was an independent predictor of in-hospital mortality in the multivariate analysis (2. 481. 00-3. 98;p=0. 004). Conclusions We have found several risk factors which are associated with polymicrobial infection in VAP patients, and high comorbidity index, late -onset VAP, multilobar pneumonia and ARDS are common findings among polymicrobial VAP patients. Polymicrobial infection was associated with poor outcomes in adults intubated VAP patients and was a risk factor for in-hospital mortality. This abstract is funded by: None

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