EAJAIC
Eurasian Journal of Anesthesiology and Intensive Care

The Eurasian Journal of Anesthesiology and Intensive Care (EAJAIC) is an independent-unbiased, peer-reviewed, "double-blind", and open-access journal of current national and international issues and reviews for original clinical and experimental research, interesting case reports, differential diagnoses, editorial opinions, letters to the editor, and educational papers in anesthesiology, algology, and intensive care medicine.

ISSN: Active
eISSN: 3023-6738
Creative Commons CC BY-NC-ND 4.0 International License.
EndNote Style

Online Manuscript System

Index
Original Article
Clinical, microbiological, and biomarker profiles of mechanically ventilated icu patients with positive tracheal aspirate cultures
Abstract
Aims: To evaluate antimicrobial resistance patterns, clinical characteristics, and inflammatory biomarker profiles in mechanically ventilated intensive care unit patients with positive tracheal aspirate cultures.
Methods: Between January 2020 and December 2024, 187 intubated intensive care unit patients with positive tracheal aspirate cultures and complete biomarker data were retrospectively analyzed. Demographic characteristics, antimicrobial resistance patterns, clinical and microbiological findings, and exploratory biomarker profiles were recorded. Exploratory receiver operating characteristic analyses were performed to descriptively assess potential relationships between selected biomarkers and in-hospital mortality.
Results: Gram-negative pathogens predominated (89.3%), and overall in-hospital mortality was 95.7%. Mortality was higher among patients with Gram-negative microorganisms than among those with Gram-positive microorganisms (97.0% vs. 83.3%, p=0.007) and increased progressively across resistance categories. APACHE II scores did not differ significantly between groups. Among the evaluated biomarkers, the Prognostic Nutritional Index, lactate, and the C-reactive protein-to-albumin ratio demonstrated moderate-to-high discriminatory performance and were associated with in-hospital mortality in exploratory receiver operating characteristic analyses.
Conclusion: Gram-negative microorganisms and antimicrobial resistance were more frequently observed among patients with adverse outcomes in this high-risk intensive care unit cohort. Biomarker findings should be interpreted as exploratory observations requiring validation in prospective studies.

Keywords : Mechanical ventilation, drug resistance microbial, critical illness, prognosis, nutritional status, nosocomial infection

Download Article


1. World Health Organization. Global Antimicrobial Resistance and Use Surveillance System (GLASS) Report 2021. World Health Organization; 2021.
2. Paramythiotou E, Routsi C. Association between infections caused by multidrug-resistant gram-negative pathogens and mortality in the intensive care unit. World J Crit Care Med. 2016;5(2):111-120. doi: 10.5492/wjccm.v5.i2.111
3. Nelson RE, Hyun D, Jezek A, Samore MH. Mortality, length of stay, and healthcare costs associated with multidrug-resistant bacterial infections among elderly hospitalized patients in the United States. Clin Infect Dis. 2021 ;74(6):1070-1080. doi: 10.1093/cid/ciab696
4. Tang A, Shi Y, Dong Q, et al. Prognostic differences in sepsis caused by gram-negative bacteria and gram-positive bacteria: a systematic review and meta-analysis. Crit Care. 2023;27(1):467. doi: 10.1186/s13054-023-04750-w
5. Evans L, Rhodes A, Alhazzani W, et al. Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021. Intensive Care Med. 2021;47(11):1181-1247. doi: 10.1007/s00134-021-06506-y
6. Deulkar P, Singam A, Mudiganti VNKS, Jain A. Lactate monitoring in intensive care: a comprehensive review of its utility and interpretation. Cureus. 2024;16(8):e66356. doi: 10.7759/cureus.66356
7. Zhang H, Wang X, Zhang Y, et al. Blood urea nitrogen-to-albumin ratio as a predictor of mortality in patients with sepsis: a retrospective cohort study. Front Med (Lausanne). 2022;9:967332. doi: 10.3389/fmed.2022.967332
8. Zhang L, Wang H, Liu X, et al. Blood urea nitrogen to albumin ratio as a prognostic factor in critically ill patients: a large cohort study. Sci Rep. 2024; 14:4411. doi: 10.1038/s41598-024-44110-7
9. Wu H, Zhou C, Kong W, Zhang Y, Pan D. Prognostic nutrition index is associated with the all-cause mortality in sepsis patients: a retrospective cohort study. J Clin Lab Anal. 2022;36(4):e24297. doi: 10.1002/jcla.24297
10. Raith EP, Udy AA, Bailey M, et al. Prognostic accuracy of the SOFA score, SIRS criteria, and qSOFA score for in-hospital mortality among adults with suspected infection admitted to the intensive care unit. JAMA. 2017; 317(3):290-300. doi:10.1001/jama.2016.20328
11. Xu HB, Xu YH, He Y, et al. Association between admission pan-immune-inflammation value and short-term mortality in septic patients: a retrospective cohort study. Sci Rep. 2024;14(1):15205. doi: 10.1038/s41598-024-66142-6
12. Zhang Z, Xu X, Ni H, Deng H. Red cell distribution width is associated with hospital mortality in unselected critically ill patients. J Thorac Dis. 2013;5(6):730-736. doi: 10.3978/j.issn.2072-1439.2013.11.14
13. Tajarernmuang P, Phrommintikul A, Limsukon A, Pothirat C, Chittawatanarat K. The role of mean platelet volume as a predictor of mortality in critically ill patients: a systematic review and meta-analysis. Crit Care Res Pract. 2016;2016:4370834. doi: 10.1155/2016/4370834
14. Lagunas-Rangel FA. Neutrophil-to-lymphocyte ratio and lymphocyte-to-C-reactive protein ratio in patients with severe COVID-19. Int Immunopharmacol. 2020;85:106507. doi: 10.1016/j.intimp.2020.106507
15. Qu R, Ling Y, Zhang YHZ, et al. Platelet-to-lymphocyte ratio is associated with prognosis in patients with coronavirus disease-19. J Med Virol. 2020; 92(9):1533-1541. doi: 10.1002/jmv.25767
16. Yang R, Chang Q, Meng X, Gao N, Wang W. Prognostic value of Systemic Immune-Inflammation Index in cancer: a meta-analysis. J Cancer. 2018; 9(18):3295-3302. doi: 10.7150/jca.25691
17. Liang L, Su Q. Systemic Immune-Inflammation Index and the short-term mortality of patients with sepsis: a meta-analysis. Biomol Biomed. 2025;25(4):798-809. doi: 10.17305/bb.2024.11494
18. Kinoshita A, Onoda H, Imai N, et al. The C-reactive protein/albumin ratio, a novel inflammation-based prognostic score, predicts outcomes in patients with hepatocellular carcinoma. Ann Surg Oncol. 2015;22(3):803-810. doi: 10.1245/s10434-014-4048-0
19. Han K, Tao Y, Wang J, Lu J. Prognostic value of blood urea nitrogen to albumin ratio in septic patients with acute kidney injury: a retrospective study based on MIMIC database. Front Med (Lausanne). 2025;12:1510919. doi: 10.3389/fmed.2025.1510919
20. Salvagno GL, Sanchis-Gomar F, Picanza A, Lippi G. Red blood cell distribution width: a simple parameter with multiple clinical applications. Crit Rev Clin Lab Sci. 2015;52(2):86-105. doi: 10.3109/10408363.2014.992064
21. Zhang Z, Xu X, Ni H, Deng H. Platelet indices are novel predictors of hospital mortality in intensive care unit patients. J Crit Care. 2014;29(5):885.e1-885.e6. doi: 10.1016/j.jcrc.2014.05.008
22. Mohri Y, Inoue Y, Tanaka K, et al. Prognostic nutritional index predicts postoperative outcome in colorectal cancer. World J Surg. 2013;37(11):2688-2692. doi: 10.1007/s00268-013-2156-9
23. Fuca G, Guarini V, Antoniotti C, et al. The pan-immune-inflammation value (PIV) as a new prognostic biomarker in metastatic colorectal cancer: results from a pooled analysis of the Valentino and TRIBE first-line trials. Ann Oncol. 2020;31(10):1535-1541. doi: 10.1016/j.annonc.2020.06.020
24. Shi Y, Wang S, Li Q. Multidrug and extensively drug-resistant Acinetobacter baumannii in pediatric intensive care unit: risk factors and clinical outcomes. BMC Infect Dis. 2020;20:555. doi:10.1186/s12879-020-05226-0
25. Islam MS, Saha S, Jahan N, Sultana N, Rahman M. Bacterial isolates from tracheal aspirates of patients in the intensive care unit and their antimicrobial susceptibility patterns. Arch Clin Biomed Res. 2021;5(6):697-711. doi: 10.26502/acbr.50170205
26. Alp E, Güven M, Yıldız O, Aygen B, Voss A. Incidence, risk factors and mortality of nosocomial pneumonia in intensive care units: a prospective study. Ann Clin Microbiol Antimicrob. 2004;3:17. doi: 10.1186/1476-0711-3-17
27. Erbay H, Yalcin AN, Serin S, et al. Nosocomial infections in the intensive care unit in a Turkish university hospital: a 2-year survey. Intensive Care Med. 2003;29(9):1482-1488. doi: 10.1007/s00134-003-1903-2
28. Ranzani OT, Zampieri FG, Forte DN, et al. C-reactive protein/albumin ratio predicts 90-day mortality of septic patients. PLoS One. 2013;8(3):e59321.
Article available in :
Volume 3, Issue 3, 2026
Page : 68-76
https://doi.org/10.51271/EAJAIC-0057
Article Information
Received : 17 Haz 2026
Accepted : 26 Tem 2026
Published : 29 Ağu 2026
Corresponding Author :

Filiz Çimen: Department of Chest Diseases, VM Medical Park Ankara Hospital, Ankara, Turkiye

[email protected]
Citation : Çimen F, Tümtürk A, Çakmak AB. Clinical, microbiological, and biomarker profiles of mechanically ventilated ICU patients with positive tracheal aspirate cultures Eur J Anesthesiol Intens Care. 2026;3(3):68-76. doi:10.51271/EAJAIC-0057

Read: 7
Download : 2
Cited: 0
_Footer