Diagnostic Heterogeneity, Microbial Profiles, and Antimicrobial Resistance in Adult Ventilator-Associated Pneumonia: A Systematic Review and Evidence Synthesis

DOI

10.2991/978-94-6239-836-8_19How to use a DOI?

Keywords

Ventilator-associated pneumonia; antimicrobial resistance; multidrug resistance; intensive care

Abstract

Ventilator-associated pneumonia (VAP) remains difficult to define because clinical, radiological, microbiological, and molecular criteria vary across studies. This systematic review evaluated diagnostic heterogeneity and synthesized microbial profiles, multidrug resistance (MDR), antimicrobial resistance (AMR), and clinical outcomes in adults receiving invasive mechanical ventilation. Original human studies published from 2020 to 2026 were identified through five bibliographic databases and supplementary evidence methods. Nineteen reports were included. The reconciled evidence set comprised seven reports from the database/master pathway and 12 from a separate other/targeted pathway. Diagnostic definitions, respiratory specimens, culture thresholds, reference standards, and resistance terminology varied substantially. Three compatible patient-level studies contributed 259 MDR cases among 378 patients (68.52%). Random-effects synthesis yielded a pooled MDR prevalence of 70.72% (95% CI, 59.40%-79.96%), with substantial heterogeneity (I²=77.31%) and a 95% prediction interval of 49.31%-85.71%. Acinetobacter baumannii predominated in one patient-level dataset. Specific resistance phenotypes were not pooled because denominators and definitions were incompatible. The findings support standardized VAP definitions, explicit denominator reporting, cautious interpretation of pooled resistance estimates, and context-adapted antimicrobial stewardship. Some historical search dates, exact executed search strings, screening-process details, and report-level provenance for the 12 other/targeted reports remain incompletely documented.

Copyright

© 2026 The Author(s)

Open Access

Open Access This chapter is licensed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/), which permits any noncommercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license and indicate if changes were made.

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TY  - CONF
AU  - Al-Muqsith
AU  - Mudatsir Mudatsir
AU  - Kulsum Kulsum
AU  - Nora Maulina
PY  - 2026
DA  - 2026/11/11
TI  - Diagnostic Heterogeneity, Microbial Profiles, and Antimicrobial Resistance in Adult Ventilator-Associated Pneumonia: A Systematic Review and Evidence Synthesis
BT  - Proceedings of the3rd Malikussaleh International Conference on Health and Disaster Medicine 2026  (MICOHEDMED 2026)
PB  - Atlantis Press
SP  - 208
EP  - 222
SN  - 2468-5739
UR  - https://doi.org/10.2991/978-94-6239-836-8_19
DO  - 10.2991/978-94-6239-836-8_19
ID  - 2026
ER  -