Etiology, incidence and risk factors of ventilator associated pneumonia in a training and research hospital intensive care unit 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 and VAP utilization rates were 0.87 and 22.88 in 1000 ventilator days, respectively. The most common three microorganisms cultured from tracheal aspirates were Pseudomonas aeruginosa (n=19), Acinetobacter species (n=11) and Staphylococcus aureus (n=10). Of the 21 risk factors evaluated, 7 factors identified were independently associated with VAP (p<0.05): 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 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. Also patient care should be individualized, and procedures like bronchoscopy, and reintubation must be performed and followed up cautiously. Besides these, data about the potential microorganisms and resistance of antibiotics to them will guide the empirical therapy.