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. 2016 Sep-Oct;33(5):512-6.
doi: 10.4103/0970-2113.188971.

Ventilator-associated pneumonia: A persistent healthcare problem in Indian Intensive Care Units!

Ashu Sara Mathai  1 , Atul Phillips  1 , Rajesh Isaac  1
Affiliations

Ventilator-associated pneumonia: A persistent healthcare problem in Indian Intensive Care Units!

Ashu Sara Mathai et al. Lung India. 2016 Sep-Oct.

Abstract

Background: Ventilator-associated pneumonia (VAP) is the most common nosocomial infection acquired by patients in the Intensive Care Unit (ICU). However, there are scarce clinical data, particularly from Indian ICUs on the occurrence of this infection.

Aims: To collect data on the incidence, microbiological profile, and outcomes of patients with VAP.

Settings and design: Tertiary level, medical-surgical ICU; prospective, observational study.

Subjects and methods: All patients who were mechanically ventilated for >48 h in the ICU during the study were enrolled. VAP was diagnosed according to the Centre for Disease Control (CDC) criteria.

Results: A total of 95 (38%) patients developed VAP infections, an incidence of 40.1 VAP infections/1000 mechanical ventilation days. These were predominantly caused by Gram-negative organisms, especially the Acinetobacter species (58 isolates, 53.2%). Many of the VAP-causing isolates (27.3%) demonstrated multidrug resistance. Patients with VAP infections experienced a significantly longer ICU stay (13 days [Interquartile Range (IQ) range = 10-21] vs. 6 days [IQ = 4-8], P < 0.0001) and total hospital stay (21 days [IQ = 14-33] vs. 11 days [IQ = 6-18], P < 0.0001). While the overall mortality rates were similar between patients with or without VAP infections, (68.4% vs. 61.3%, P = 0.200), on subgroup analysis, elderly patients (>60 years) and those with higher Acute Physiology and Chronic Health Evaluation II scores at admission had significantly greater mortality rates if they acquired a VAP infection (P = 0.010).

Conclusions: VAP continues to be a major threat to patients who are admitted for mechanical ventilation into the critical care unit, emphasizing the urgent need for infection control measures.

Keywords: Incidence; Intensive Care Unit; microbiological profile; outcome; ventilator-associated pneumonia.

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Figures

Figure 1
Figure 1
The process of screening, selection and the outcomes of patients studied
Figure 2
Figure 2
Microbiological organisms isolated in patients with ventilator-associated pneumonia infections (with percentages). Gram-negative organisms caused a large majority of ventilator-associated pneumonia infections with Acinetobacter being the single largest species isolated
See this image and copyright information in PMC

References

    1. Rosenthal VD, Maki DG, Jamulitrat S, Medeiros EA, Todi SK, Gomez DY, et al. International Nosocomial Infection Control Consortium (INICC) report, data summary for 2003-2008, issued June 2009. Am J Infect Control. 2010;38:95–104.e2. - PubMed
    1. Chawla R. Epidemiology, etiology, and diagnosis of hospital-acquired pneumonia and ventilator-associated pneumonia in Asian countries. Am J Infect Control. 2008;36(4 Suppl):S93–100. - PubMed
    1. American Thoracic Society; Infectious Diseases Society of America. Guidelines for the management of adults with hospital-acquired, ventilator-associated, and healthcare-associated pneumonia. Am J Respir Crit Care Med. 2005;171:388–416. - PubMed
    1. Arabi Y, Al-Shirawi N, Memish Z, Anzueto A. Ventilator-associated pneumonia in adults in developing countries: A systematic review. Int J Infect Dis. 2008;12:505–12. - PubMed
    1. Heyland DK, Cook DJ, Griffith L, Keenan SP, Brun-Buisson C. The attributable morbidity and mortality of ventilator-associated pneumonia in the critically ill patient. The Canadian Critical Trials Group. Am J Respir Crit Care Med. 1999;159(4 Pt 1):1249–56. - PubMed

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