Pak J Med Sci. 2016 Jul-Aug;32(4):817-22. doi: 10.12669/pjms.324.10381.
An assessment of ventilator-associated pneumonias and risk factors identified in the Intensive Care Unit.
Pakistan journal of medical sciences
Mevlut Karatas, Sedat Saylan, Ugur Kostakoglu, Gurdal Yilmaz
Affiliations
Affiliations
- Mevlut Karatas, Assistant Professor, Department of Pulmonology, Faculty of Medicine, Recep Tayyip Erdogan University, Rize, Turkey.
- Sedat Saylan, Assistant Professor, Department of Anesthesiology and Reanimation, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey.
- Ugur Kostakoglu, Assistant Professor, Department of Infection Diseases and Clinic Microbiology, Faculty of Medicine, Recep Tayyip Erdogan University, Rize, Turkey.
- Gurdal Yilmaz, Associate Professor, Department of Infection Diseases and Clinic Microbiology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey.
PMID: 27648020
PMCID: PMC5017083 DOI: 10.12669/pjms.324.10381
Abstract
OBJECTIVES: Ventilator-associated pneumonia (VAP) is a significant cause of hospital-related infections, one that must be prevented due to its high morbidity and mortality. The purpose of this study was to evaluate the incidence and risk factors in patients developing VAP in our intensive care units (ICUs).
METHODS: This retrospective cohort study involved in mechanically ventilated patients hospitalized for more than 48 hours. VAP diagnosed patients were divided into two groups, those developing pneumonia (VAP(+)) and those not (VAP(-)).\.
RESULTS: We researched 1560 patients in adult ICUs, 1152 (73.8%) of whom were mechanically ventilated. The MV use rate was 52%. VAP developed in 15.4% of patients. The VAP rate was calculated as 15.7/1000 ventilator days. Mean length of stay in the ICU for VAP(+) and VAP(-) patients were (26.7±16.3 and 18.1±12.7 days (p<0.001)) and mean length of MV use was (23.5±10.3 and 12.6±7.4 days (p<0.001)). High APACHE II and Charlson co-morbidity index scores, extended length of hospitalization and MV time, previous history of hospitalization and antibiotherapy, reintubation, enteral nutrition, chronic obstructive pulmonary disease, cerebrovascular disease, diabetes mellitus and organ failure were determined as significant risk factors for VAP. The mortality rate in the VAP(+) was 65.2%, with 23.6% being attributed to VAP.
CONCLUSION: VAPs are prominent nosocomial infections that can cause considerable morbidity and mortality in ICUs. Patient care procedures for the early diagnosis of patients with a high risk of VAP and for the reduction of risk factors must be implemented by providing training concerning risk factors related to VAP for ICU personnel, and preventable risk factors must be reduced to a minimum.
Keywords: Infection; Intensive care unit; Ventilator associated pneumonia
Conflict of interest statement
Declaration of interests: None.
References
- Ann Ig. 2013 Jul-Aug;25(4):281-9 - PubMed
- Chest. 1999 Feb;115(2):462-74 - PubMed
- PLoS One. 2015 Aug 11;10(8):e0135336 - PubMed
- J Crit Care. 2008 Mar;23(1):126-37 - PubMed
- Respir Care. 2005 Jun;50(6):725-39; discussion 739-41 - PubMed
- Anesthesiology. 2002 Jul;97(1):148-56 - PubMed
- Am J Respir Crit Care Med. 2005 Feb 15;171(4):388-416 - PubMed
- J Chronic Dis. 1987;40(5):373-83 - PubMed
- Am J Infect Control. 2008 Jun;36(5):309-32 - PubMed
- Lancet Infect Dis. 2011 Oct;11(10):728; author reply 731-2 - PubMed
- Am J Respir Crit Care Med. 2001 Mar;163(4):874-80 - PubMed
- Jpn J Infect Dis. 2005 Oct;58(5):297-302 - PubMed
- Ann Clin Microbiol Antimicrob. 2006 Apr 06;5:7 - PubMed
- J Hosp Infect. 2011 Aug;78(4):284-8 - PubMed
- Respir Care. 2003 Jul;48(7):681-8 - PubMed
- Crit Care Med. 2010 Oct;38(10):1947-53 - PubMed
- Crit Care Med. 2015 Sep;43(9):1798-806 - PubMed
- Ann Intern Med. 2001 Nov 20;135(10):847-57 - PubMed
- Braz J Infect Dis. 2007 Jun;11(3):339-44 - PubMed
- Am J Respir Crit Care Med. 2011 Nov 15;184(10):1133-9 - PubMed
- Minerva Anestesiol. 2014 Oct;80(10 ):1076-83 - PubMed
- J Infect. 2006 Aug;53(2):98-105 - PubMed
- Lancet Infect Dis. 2013 Aug;13(8):665-71 - PubMed
- Infect Control Hosp Epidemiol. 2004 Mar;25(3):251-5 - PubMed
- Crit Care Med. 1985 Oct;13(10):818-29 - PubMed
Publication Types