{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T17:29:19Z","timestamp":1793035759405,"version":"4.5.0"},"reference-count":81,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2025,1,3]],"date-time":"2025-01-03T00:00:00Z","timestamp":1735862400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100014677","name":"George Emil Palade University of Medicine, Pharmacy, Science, and Technology of T\u00e2rgu Mure\u0219","doi-asserted-by":"publisher","award":["170\/1\/09.01.2024"],"award-info":[{"award-number":["170\/1\/09.01.2024"]}],"id":[{"id":"10.13039\/501100014677","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>Background\/Objectives: Ventilator-associated pneumonia (VAP) is the most common nosocomial infection encountered in the intensive care unit (ICU) and is associated with prolonged hospitalization and increased mortality. We evaluated the causative pathogens involved and their resistance to the major classes of antibiotics in patients with VAP and assessed the differences between patients with and without coronavirus disease 2019 (COVID-19). Materials and Methods: This study was a single-center, cross-sectional, retrospective analysis involving 122 patients who were hospitalized in the ICU of T\u00e2rgu Mure\u0219 County Clinical Hospital from 1 April 2021, to 1 April 2023. This study compares patients with VAP in COVID-19 and non-COVID-19 groups, examining the clinical progression, duration of ventilation and hospitalization, mortality, pathogen distribution, and the emergence of multidrug-resistant strains. Results: A length of stay in the ICU exceeding 11.5 days was associated with the development of multidrug-resistant (MDR) infections (AUC: 0.708, p &lt; 0.001). Similarly, a duration of MV exceeding 196 h was associated with MDR acquisition (AUC: 0.695, p = 0.002). Additionally, a Clinical Pulmonary Infection Score (CPIS) greater than 5 was associated with MDR development (AUC: 0.854, p &lt; 0.001) in the whole group of patients. The most commonly isolated strains were Acinetobacter spp., Pseudomonas spp., Klebsiella spp., and Staphylococcus aureus. Among non-COVID-19 patients, there was a notably higher frequency of MDR Acinetobacter baumannii. A bacterial resistance to carbapenems was found in Acinetobacter spp. (51.6%), Klebsiella spp. (22.6%), and Pseudomonas spp. (25.8%). Conclusions: COVID-19 patients experienced longer ventilation, higher mortality, and an increased risk of developing MDR. Carbapenem resistance was universal in Acinetobacter spp. and Klebsiella pneumoniae, whereas resistance in Pseudomonas aeruginosa was more prevalent among non-COVID-19 patients. The Clinical Pulmonary Infection Score (CPIS) strongly correlates with developing MDR pathogens in both patient groups.<\/jats:p>","DOI":"10.3390\/antibiotics14010028","type":"journal-article","created":{"date-parts":[[2025,1,3]],"date-time":"2025-01-03T05:02:02Z","timestamp":1735880522000},"page":"28","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["Mechanical Ventilator-Associated Pneumonia in the COVID-19 Pandemic Era: A Critical Challenge in the Intensive Care Units"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-6297-0378","authenticated-orcid":false,"given":"Mircea","family":"Stoian","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Intensive Care, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology of T\u00e2rgu Mures, 540139 Targu Mures, Romania"},{"name":"Intensive Care Unit, Mures Clinical County Hospital, Street Gheorghe Marinescu No 1, 540103 Targu Mures, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adina","family":"Andone","sequence":"additional","affiliation":[{"name":"Gastroenterology Department, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology of T\u00e2rgu Mures, 540142 Targu Mures, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sergiu Rare\u0219","family":"B\u00e2ndil\u0103","sequence":"additional","affiliation":[{"name":"Orthopedic Surgery and Traumatology Service, Marina Baixa Hospital, Av. Alcade En Jaume Botella Mayor, 03570 Villajoyosa, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5710-9109","authenticated-orcid":false,"given":"Danusia","family":"Oni\u0219or","sequence":"additional","affiliation":[{"name":"Gastroenterology Department, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology of T\u00e2rgu Mures, 540142 Targu Mures, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sergiu \u0218tefan","family":"Laszlo","sequence":"additional","affiliation":[{"name":"Intensive Care Unit, Mures Clinical County Hospital, Street Gheorghe Marinescu No 1, 540103 Targu Mures, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriela","family":"Lupu","sequence":"additional","affiliation":[{"name":"Intensive Care Unit, Mures Clinical County Hospital, Street Gheorghe Marinescu No 1, 540103 Targu Mures, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alina","family":"Danielescu","sequence":"additional","affiliation":[{"name":"Intensive Care Unit, Mures Clinical County Hospital, Street Gheorghe Marinescu No 1, 540103 Targu Mures, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4004-9648","authenticated-orcid":false,"given":"Drago\u0219-Florin","family":"Baba","sequence":"additional","affiliation":[{"name":"Department of Cell and Molecular Biology, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540142 Targu Mures, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2880-4337","authenticated-orcid":false,"given":"Anca Meda","family":"V\u0103sie\u0219iu","sequence":"additional","affiliation":[{"name":"Infectious Disease, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology of Targu Mures, 540136 Targu Mures, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-0922-8565","authenticated-orcid":false,"given":"Andrei","family":"Manea","sequence":"additional","affiliation":[{"name":"Doctoral School of Medicine and Pharmacy, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540139 Targu Mures, Romania"},{"name":"Department of Radiology, Clinical Emergency County Hospital of Targu Mures, 540136 Targu Mures, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6862-4926","authenticated-orcid":false,"given":"Adina","family":"Stoian","sequence":"additional","affiliation":[{"name":"Department of Pathophysiology, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology of Targu Mures, 540136 Targu Mures, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,1,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Rouyer, M., Strazzulla, A., Youbong, T., Tarteret, P., Pitsch, A., de Pontfarcy, A., Cassard, B., Vignier, N., Pourcine, F., and Jochmans, S. 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