• K A Khalil, M Alsultan, and N A Daher.
• Department of Internal Medicine, Damascus University- Faculty of Medicine, Damascus, Syria.
• J Postgrad Med. 2025 Jan 2.

IntroductionThis study aimed to determine the bacterial profile and their antibiotic spectrum in patients with ventilator-associated pneumonia (VAP) and investigate the risk factors for VAP and the presence of multidrug-resistant (MDR) pathogens.Materials And MethodsA cross-sectional study was included 105 patients with clinically suspected VAP in intensive care units (ICUs) of two university hospitals from Syria, between January 2023 and February 2024. Culture-positive included 69 samples (65.7%), which were classified based on post-intubation as early-onset (<5 days) or late-onset (≥5 days).ResultsGram-negative and Gram-positive bacteria were observed in 82.6% and 17.4%; respectively. Early and late-onset VAP was reported in 30 (43.5%) and 39 (56.5%) patients; respectively. The primary cause of early-onset VAP was Acinetobacter and Enterobacter , whereas Klebsiella and Acinetobacter were the main causes of late-onset VAP. Gram-negative showed a high resistance to fluoroquinolones (91.2%), carbapenems (78.9% for imipenem and 86% for meropenem), and amikacin (83.2%), while all were sensitive to colistin. Gram-positive was sensitive to tetracycline, vancomycin, linezolid, tigecycline, and trimethoprim-sulfamethoxazole. MDR was observed in 55 patients (79.7%) and in early (76.9%) and late-onset (83.3%) VAP. There were no risk factors favoring MDR or early compared to late-onset VAP.ConclusionsThe study revealed a high prevalence of Gram-negative among VAP patients. A significant prevalence of MDR pathogens was observed in early and late-onset VAP, along with high resistance to carbapenems. This necessitates a reassessment of the current use of antibiotics and highlights the need for further studies to choose alternative treatments for empirical antibiotic coverage.Copyright © 2025 Journal of Postgraduate Medicine.

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