What question did this study set out to answer?

This study aims to analyze the microbiological profile of infections and their effects on mortality in critically ill oncology patients.

March 17, 2026The Brazilian Journal of Infectious Diseases0 citationsOpen Access

Ventilator-Associated Tracheobronchitis and Pneumonia in a Brazilian Oncology Hospital: Bacterial Profile and Mortality Analysis

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VOVitor Falcão de OliveiraUniversidade de São Paulo DLDébora de Oliveira LopesFederal University of São João del-Rei VCValdirene Santos Folli CabralInstituto do Câncer do Estado de São Paulo

Key Points

This study aims to analyze the microbiological profile of infections and their effects on mortality in critically ill oncology patients.
Retrospective analysis conducted in an oncology ICU in Brazil (January to December 2024)
Evaluation of bacterial frequencies and resistance patterns in VAP and VAT cases
Statistical analysis using chi-square tests to assess association between multidrug resistance and mortality
VAT was more common than VAP, affecting 59% and 41% of patients respectively
Overall 14-day mortality was 55%, with significantly higher rates in patients with positive blood cultures (86% compared to 49%)
High rates of multidrug resistance were observed, particularly in Acinetobacter baumannii (82%)

Abstract

Most evidence on mortality related to ventilator-associated pneumonia (VAP) and ventilator-associated tracheobronchitis (VAT) comes from general intensive care units (ICUs), with limited data on critically ill oncology patients. This study aimed to characterize the microbiologic profile and resistance patterns in an oncology hospital and to assess their impact on 14-day mortality. Retrospective analysis of VAP and VAT cases in an oncology ICU in Brazil (January to December 2024), evaluating bacterial frequencies, multidrug-resistant organisms, and mortality. The chi-square test was used to assess the association of multidrug resistance (MDR) and sample type (blood or respiratory secretion) with mortality. Among 85 ICU patients, VAT was more frequent (59%) than VAP (41%). Most were male (60%), with a median age of 61 years, and had solid tumors (85%), mainly lung and head-and-neck cancers. Of 109 samples, Pseudomonas aeruginosa (27%), Klebsiella pneumoniae (20%), and Stenotrophomonas maltophilia (17%) were the most common pathogens. MDR rates were particularly high in Acinetobacter baumannii (82%). The same microorganisms were isolated from blood and respiratory tract in four patients. Patients infected with S. maltophilia, Acinetobacter spp., Serratia marcescens, P. aeruginosa, and K. pneumoniae had longer hospital stays, with median durations >10 days. Device use was also prolonged in patients with infections due to S. marcescens, K. pneumoniae, and Acinetobacter spp., with median device duration >7 days. Overall 14-day mortality was 55%. MDR was not associated with mortality (p = 0.3), but infections with positive blood cultures were associated with significantly higher mortality (86% vs. 49%; p = 0.012). This study provides valuable information on the microbiologic profile of patients with VAP and VAT in an oncology ICU and its impact on mortality. Mortality was not associated with MDR, possibly reflecting the high baseline risk due to underlying onco-hematologic conditions. However, patients with positive blood cultures had significantly higher mortality, suggesting a more invasive infectious process.

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Cite This Study

Oliveira et al. (Sun,) studied this question.

synapsesocial.com/papers/69b8ef6ddeb47d591b8c58b0 https://doi.org/https://doi.org/10.1016/j.bjid.2026.105137

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