The objective of the retrospective review study carried out by A.F. Shorr et al. (United States), was to determine the effect of infection with methicillin-resistant Staphylococcus aureus (MRSA) on the length of stay in the intensive care unit (ICU) of patients respiratory pneumonia (VAP) who received adequate antibacterial therapy initially.

The study included data from patients with a bronchoscopically confirmed diagnosis of PVA caused by MRSA or methicillin S.aureus (MSSA) who initially received adequate antibacterial therapy (for patients with pneumonia caused by MRSA, vancomycin 15 mg / kg iv (twice daily) and undergoing ICU treatment in various clinical studies. The authors performed a comparative analysis of indicators of patients with PAV caused by MRSA, with those of patients with PAV caused by MSSA, taking into account concomitant factors, including demographic characteristics, reasons for intensive care hospitalization and transfer to artificial pulmonary ventilation, severity of condition of the patient at the time of ICU admission and at the time of diagnosis of VAP, the duration of mechanical ventilation before and after the development of VAP.

Despite the initially adequate antibacterial treatment, the average length of stay in the intensive care unit was significantly higher in patients infected with MRSA (33 days vs 22 days; p = 0.047), while the average number of days spent outside intensive care these patients had, respectively, less (0 days vs 5 days; p = 0.011). Analysis of patient survival using the proportional risk model (Cox model) revealed a number of factors predisposing to ICU retention: the oxygenation index (PaO2 / FiO2) time of VAP diagnosis, duration of ventilation before and after VAP and reason for patient transfer to the artificial. pulmonary ventilation. In addition, MRSA infection has doubled the likelihood that the patient will require additional treatment in an intensive care unit compared to MSSA infection (risk ratio 2.08; confidence interval at 95% 1.09-3095; P = 0.025).

Thus, the development of the patient's VAP caused by MRSA increases the length of their stay in intensive care, which, in turn, increases the economic costs of treatment, even in patients who initially received adequate antibacterial therapy. According to the authors, in addition to adequate antibiotic therapy, there is a need to take additional measures to combat MRSA infection in patients with VAP.