The importance of antimicrobial resistance in hospital-acquired and ventilator-associated pneumonia

Hospital-acquired pneumonia (HAP) represents the most common nosocomial infection occurring among mechanically ventilated patients in the intensive care unit setting. Increasingly, HAP is associated with antibiotic-resistant bacteria. Antimicrobial resistance has emerged as an important determinant of mortality for patients with HAP and ventilator-associated pneumonia (VAP). This is largely due to the increasing presence of pathogenic micro-organisms with resistance to existing antimicrobial agents resulting in the administration of inappropriate treatment. Escalating antimicrobial resistance has also been associated with greater overall healthcare costs as a result of prolonged hospitalizations and convalescence associated with antibiotic treatment failures, the need to develop new antimicrobial agents, and the implementation of broader infection control and public health interventions aimed at curbing the spread of antibiotic-resistant pathogens. Effective strategies for the prevention and treatment of HAP and VAP attributed to antibiotic-resistant bacteria are available and should be aggressively implemented. This is especially important given the limited availability of new antimicrobial drug classes for the foreseeable future.