Incidence of ventilator-associated pneumonia: Egyptian study

Abstract

Background Despite different ICU admission causes, ventilator-associated pneumonia (VAP) is still a common cause of mortality and morbidity in intubated patients and impedes obvious progression in diagnostic modalities and management of these infections. Aim of study The aim of this study was to estimate VAP incidence in Tanta University Hospitals ICUs. Settings and design This was a crossover observational study. Patients and methods This was a one-year study (April 2015 to March 2016), including patients on invasive ventilation who developed VAP, with evaluation of admission and ventilation causes, isolation of causative organisms, and study of used antibiotics and ventilation modes. Statistical analysis Data were statistically analyzed using the SPSS software for Windows (IBM SPSS Statistics 21.0). Results It is a statistics based study aimed to trace infection incidence in national hospital ICUs. Among 222 admitted patients, only 38.4% fulfilled the criteria of VAP. Admission was because of cardiovascular impairment, cardiac arrest, respiratory failure, or head trauma. The ventilation mode at VAP time was assisted control (75%) and synchronized intermittent mandatory ventilation (25%). The minimum intubation period was 7 days, whereas the maximum period was 37 days. Isolated organisms were Pseudomonas (37.5%), Klebsiella (25%), Staphylococcus (20.8%), and methicillin-resistant Staphylococcus aureus (4.2%). The antibiotics used were amikacin, imipenem, vancomycin, levofloxacin, ceftazidime, and teicoplanin (29, 25, 21, 12.5, 8.3, and 4.2%, respectively). The minimum period of antibiotic used was 5 days, whereas the maximum period was 35 days. The highest incidence of VAP occurred in February, whereas the lowest incidence occurred in July. Conclusion The incidence of VAP is still high and varies according to the intubation cause and period, and the underlying morbidity. More efforts must be made to prevent, diagnose, and manage infection early and properly to reduce patient suffering and to reduce the burden on the serving hospitals.