Ventilator associated pneumonia, incidence and risk factors in emergency intensive care unit Zagazig university hospitals

Abstract

Background: VAP is a common complication in patients receiving mechanical ventilation, and considered to be one of the most common causes of morbidity and mortality, VAP continues to be a major challenge to the critical care physicians and a common nosocomial infection occurring in mechanically ventilated patients, knowledge of important risk factors predisposing to VAP may be useful in implementing simple and effective preventive measures. Objective: To determine the incidence, risk factors of ventilator-associated pneumonia and to get appropriate preventive strategies or institutional policies to decrease rate of infection. Patients and method: One hundred mechanically ventilated patients admitted in the emergency and trauma ICU in Zagazig university hospitals were included in a prospective study to identify the incidence and risk factors of VAP. The clinical suspicion of VAP was done by simplified version of Clinical Pulmonary Infection Score (CPIS) >6. Identification of VAP pathogens was done through specimen collection by bronchoalveolar lavage using fiberoptic bronchoscope thorough the trachea via ETT or tracheostomy tube, the sample was sent for quantitative culture. Results: The incidence of VAP was 22%, impaired consciousness, reintubation and tracheostomy are the significant risk factors of late onset VAP, regarding to the causative pathogens of VAP, klebseilla pneumoniae, acinitobacter and pseudomonas are the most commonly detected pathogens. Conclusion: Incidence of VAP was 22%. Tracheostomy, reintubation and impaired consciousness are highly significant risk factor for the development of VAP mostly late onset VAP.

Keywords

• Ventilator-associated pneumonia (VAP)
• Intensive-care-unit (ICU)
• Mechanically ventilation (MV)