Etiology, incidence and risk factors of ventilator associated pneumonia in an intensive care unit of a training and research hospital in Istanbul

SUMMARY In this prospective study, we aimed to identify the factors associated with the development of ventilator- associated pneumonia (VAP) and examine the etiology, and incidence of VAP. Between November 2007 and June 2008, 148 patients who required mechanical ventilation for longer than 48 hours were evaluated. VAP was observed in 54 patients (36 %). Mechanical ventilator utilizationrate was 0.87, and VAP rate in 1000 ventilator days was 22.88. The most common three microorganisms cultured from tracheal aspirates were Pseudomonas aeruginosa (n=19), Acinetobacter spp.(n=11), and Staphylococcus aureus (n=10). Of the 21 risk factors evaluated, 7 factors identified were independently associated with VAP (p<0.05) such as shock, coma (p<0.0006), antibiotic usage for at least 1 month prior to admission (p<0.04), nasogastric tube insertion (p<0.01), invasive procedures such as bronchoscopy, tracheotomy (p<0.0001), reintubation (p<0.017), intubation lasting for more than 5 days (p<0.0001), and smoking (p<0.014). Intensive Care Unit (ICU) clinicians should be aware of the risk factors for VAP to minimize the risk of VAP, patient care should be individualized, and procedures like bronchoscopy, reintubation must be performed and followed up cautiously. Besides these, data about the potential microorganisms and those resistant to antibiotics will guide the empirical therapy.