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The influence of MDR colonisation and infection on weaning success (category 3a and 3b), successful prolonged weaning from invasive mechanical ventilation (IMV) with or without the need for non-invasive ventilation (NIV) compared with category 3c (weaning failure 3cI or death 3cII) was investigated. The pathogen groups considered were: multidrug-resistant gram-negative bacteria (MDRGN), methicillin-resistant <jats:italic>Staphylococcus aureus<\/jats:italic> (MRSA) and vancomycin-resistant <jats:italic>Enterococcus spp.<\/jats:italic> (VRE).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>A total of 206 patients were studied, of whom 91 (44.2%) showed evidence of MDR bacteria (32% VRE, 1.5% MRSA and 16% MDRGN), with 25 patients also meeting the criteria for MDR infection. 70.9% of the 206 patients were successfully weaned from IMV, 8.7% died. In 72.2% of cases, nosocomial pneumonia and other infections were the main cause of death. Patients with evidence of MDR (infection and colonisation) had a higher incidence of weaning failure than those without evidence of MDR (48% vs. 34.8% vs. 21.7%). In multivariate analyses, MDR infection (OR 4.9, <jats:italic>p<\/jats:italic>\u2009=\u20090.004) was an independent risk factor for weaning failure, along with male sex (OR 2.3, <jats:italic>p<\/jats:italic>\u2009=\u20090.025), Charlson Comorbidity Index (OR 1.2, <jats:italic>p<\/jats:italic>\u2009=\u20090.027), pH (OR 2.7, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and duration of IMV before admission (OR 1.01, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). In addition, MDR infection was the only independent risk factor for death (category 3cII), (OR 6.66, <jats:italic>p<\/jats:italic>\u2009=\u20090.007).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Patients with MDR infection are significantly more likely to die during the weaning process. There is an urgent need to develop non-antibiotic approaches for the prevention and treatment of MDR infections as well as clinical research on antibiotic stewardship in prolonged weaning as well as in ICUs.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12931-024-02694-5","type":"journal-article","created":{"date-parts":[[2024,2,5]],"date-time":"2024-02-05T11:05:08Z","timestamp":1707131108000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Role of multidrug-resistant bacteria in weaning from invasive mechanical ventilation"],"prefix":"10.1186","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7006-7054","authenticated-orcid":false,"given":"Julia D.","family":"Michels-Zetsche","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vicky","family":"Gassmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jasmin K.","family":"Jasuja","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Neetz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philipp","family":"H\u00f6ger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Meis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simone","family":"Britsch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Urte","family":"Sommerwerck","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"F\u00e4hndrich","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florian","family":"Bornitz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael M.","family":"M\u00fcller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felix J.F.","family":"Herth","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franziska C.","family":"Trudzinski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,2,5]]},"reference":[{"issue":"18","key":"2694_CR1","doi-asserted-by":"crossref","first-page":"e166","DOI":"10.1055\/s-0042-112345","volume":"141","author":"G WeanNet Study","year":"2016","unstructured":"WeanNet Study G. 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The necessity for informed consent was waived by the Ethics Committee due to the retrospective nature of the study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not required.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Patient consent for publication"}},{"value":"Julia D. Michels, Benjamin Neetz, Jan N. Meis, Simone Britsch, Florian Bornitz, Michael M. M\u00fcller, Felix J.F. Herth and Franziska C. Trudzinski report a relationship with Federal Joint Committee of Doctors Hospitals and Health Insurers that includes: funding grants for the PRiVENT project.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"Patients with MDR infection in prolonged weaning are significantly more likely to have weaning failure or die.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Take home message"}}],"article-number":"69"}}