Clinical characteristics of ventilator-associated pneumonia patients and control patients

Introduction

Ventilator-associated pneumonia (VAP) represents 80% of all nosocomial pneumonia. The aim of this study is an epidemiological, performance and outcome evaluation of an ICU, focused in VAP.

Methods

The study was performed in a 13-bed ICU located in São Paulo, Brazil, during 2003. It was a retrospective study, where all consecutive patients admitted were included. All data were collected and analysed in a Brazilian system of performance and quality in the ICU, called QuaTI^®. Statistical analyses were done, supported by the EpiInfo 2002 software. Clinical characteristics of all patients were presented and then two groups were analysed and compared: VAP group (n = 28) and control group (n = 231) composed of ventilated patients who did not develop VAP.

Results

From 11 January to 31 December, 483 patients were admitted; 55.69%, were male; median age was 59 years, 362 medical and 121 surgical patients; medium length of stay was 8.91 ± 13.07 days. APACHE II median score was 11.78 ± 7.13; mortality rate was 29.6% and standard mortality rate, calculated by APACHE II, was 1.01. The rate of ventilated patients was 259/483 (53.62%). The VAP incidence was 10.81% and the rate was 10.84 per 1000 ventilator days. The infection agent was identified in 15 patients by bronchoalveolar lavage or blood cultures. The more prevalent were Pseudomonas aeuriginosa (6/28), Klebisiella pneumoniae (2/28), Staphylococcus aureus (2/28).

Conclusions

VAP did not increase mortality but improved ventilated days, ICU length of stay and assistance costs. The APACHE II score was significantly higher in patients who developed VAP. P. aeuriginosa was the predominant pathogen.

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