Ventilator Associated Pneumonia in a Tertiary Care Hospital: Incidence, Risk Factors and Etiological Agents
Nahla Y. Sahlo
Department of Microbiology and Immunology, Faculty of Medicine, Cairo University, Egypt.
Lamiaa A. Madkour *
Department of Microbiology and Immunology, Faculty of Medicine, Cairo University, Egypt.
Youssef M. Soliman
Department of Chest Diseases, Faculty of Medicine, Cairo University, Egypt.
*Author to whom correspondence should be addressed.
Abstract
Aims: With an escalating mortality rate reaching 50%, ventilator associated pneumonia (VAP) continues to pose an enormous threat to ICU patients worldwide.
Study Design: Prospective cohort study.
Place and Duration: The study was conducted from March 2014 through February 2015 at Kasralainy University Hospital. Hundred patients who were on Mechanical Ventilation (MV) for more than 48 hours were monitored for the development of VAP.
Methodology: We endeavored to identify the incidence, risk factors, and the most common etiological pathogens of VAP in ICU patients.
Results: Out of the 100 enrolled patients, 34 patients developed VAP. With univariate analysis, it was proven that the duration of MV and trauma were significant risk factors for VAP. The most common isolated pathogens were Klebsiella, Pseudomonas, and Acinetobacter. Alarmingly, 89.8% of the isolated organisms were multi-drug resistant (MDR).
Conclusion: The duration of MV has to be reduced to minimize the incidence and morbidity associated with VAP. Likewise, unnecessary prolonged hospitalization should be avoided. The choice of antibiotics should be judicial and guided by sensitivity patterns of the pathogens. These predictors, however, need further work to validate reliability.
Keywords: VAP, risk factors, nosocomial pneumonia, MDR pathogens.