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Epidemiology of ventilator-associated pneumonia in ICU patients

Introduction

Ventilator-associated pneumonia (VAP) is the most frequent ICU-acquired infection among patients receiving mechanical ventilation. The aim of our study was to test the incidence, the rate of mortality and the impact of VAP to prolong the duration of ICU stay, in our both medical and surgical ICU.

Methods

During a 32-month period, from November 2005 to August 2008, 127 patients were admitted to our ICU; 114 of them had received mechanical ventilation and were included retrospectively in our study. The sum of the mechanical ventilation days was 1,330. The patients compared were divided into two groups. Group A included 28 patients (24.5% of the total) with VAP (five early and 23 late), and Group B included 86 patients with no VAP.

Results

The incidence of VAP was 24.5% in patients receiving mechanical ventilation, or 21 of episodes per 1,000 days of mechanical ventilation. We detected no statistically significant difference among the two groups according to age (mean ± SD): 64.62 ± 15.9 and 64.53 ± 16.9, P = 0.97, nor the APACHE II score (mean ± SD): 19.96 ± 6.8 and 19.33 ± 7.79, P = 0.7. We detected a statistically significant difference among the two groups according to the duration of ICU stay (days, mean ± SD): 33.75 ± 20 and 10.27 ± 11.29, P < 0.0001. We detected a difference according to the rate of mortality, 32.14% and 22.09%, respectively, although not statistically significant, P = 0.31, OR = 1.67.

Conclusion

The incidence of VAP in our study is similar to other studies, which varies from 8% to 28%. VAP prolongs the duration of ICU stay, while the attributable mortality rate for VAP is still debated. Nevertheless, we have to improve our clinical approach in order to recognize better the risk factors and to develop a more effective prevention program.

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Vakalos, A., Kolesidis, K. & Tsigaras, G. Epidemiology of ventilator-associated pneumonia in ICU patients. Crit Care 13, P299 (2009). https://doi.org/10.1186/cc7463

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Keywords

  • Public Health
  • Mortality Rate
  • Pneumonia
  • Mechanical Ventilation
  • Emergency Medicine