Ventilator-Associated Pneumonia, Multidrug-Resistant Bacteremia and Infection Control Interventions in an Intensive Care Unit: Analysis of Six-Year Time-Series Data
Amalia Papanikolopoulou,
Helena C. Maltezou,
Athina Stoupis,
Anastasia Pangalis,
Christos Kouroumpetsis,
Genovefa Chronopoulou,
Yannis Kalofissoudis,
Evangelos Kostares,
Fotini Boufidou,
Maria Karalexi,
Vasiliki Koumaki,
Nikos Pantazis,
Athanasios Tsakris,
Maria Kantzanou
Affiliations
Amalia Papanikolopoulou
Clinical Pharmacology Department, Athens Medical Center, 15125 Athens, Greece
Helena C. Maltezou
Directorate of Research, Studies and Documentation, National Public Health Organization, 15123 Athens, Greece
Athina Stoupis
Clinical Infectious Diseases Department, Athens Medical Center, 15125 Athens, Greece
Anastasia Pangalis
Biopathology Department Athens Medical Center, Marousi, 15125 Athens, Greece
Christos Kouroumpetsis
Intensive Care Unit, Athens Medical Center, Marousi, 15125 Athens, Greece
Genovefa Chronopoulou
Biopathology Department Athens Medical Center, Marousi, 15125 Athens, Greece
Yannis Kalofissoudis
Quality Assurance Department, Athens Medical Center, Marousi, 15125 Athens, Greece
Evangelos Kostares
Department of Microbiology, School of Medicine, National and Kapodistrian University of Athens, 75 Mikras Asias Street, 11527 Athens, Greece
Fotini Boufidou
Neurochemistry and Biological Markers Unit, 1st Department of Neurology, School of Medicine, Eginition Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece
Maria Karalexi
Department of Microbiology, School of Medicine, National and Kapodistrian University of Athens, 75 Mikras Asias Street, 11527 Athens, Greece
Vasiliki Koumaki
Department of Microbiology, School of Medicine, National and Kapodistrian University of Athens, 75 Mikras Asias Street, 11527 Athens, Greece
Nikos Pantazis
Department of Hygiene, Epidemiology and Medical Statistics, Faculty of Medicine, School of Health Sciences, National and Kapodistrian University of Athens, 11527 Athens, Greece
Athanasios Tsakris
Department of Microbiology, School of Medicine, National and Kapodistrian University of Athens, 75 Mikras Asias Street, 11527 Athens, Greece
Maria Kantzanou
Department of Microbiology, School of Medicine, National and Kapodistrian University of Athens, 75 Mikras Asias Street, 11527 Athens, Greece
Ventilator-associated pneumonia (VAP) occurs more than 48h after mechanical ventilation and is associated with a high mortality rate. The current hospital-based study aims to investigate the association between VAP rate, incidence of bacteremia from multidrug-resistant (MDR) pathogens, and infection control interventions in a single case mix ICU from 2013 to 2018. Methods: The following monthly indices were analyzed: (1) VAP rate; (2) use of hand hygiene disinfectants; (3) isolation rate of patients with MDR bacteria; and (4) incidence of bacteremia/1000 patient-days (total cases, total carbapenem-resistant cases, and carbapenem-resistant Acinetobacter baumannii, Pseudomonas aeruginosa, and Klebsiella pneumoniae cases separately). Results: Time trends of infection control interventions showed increased rates in isolation of patients with MDR pathogens (p p =0.001). The last four years of the study an annual decrease of VAP rate by 35.12% (95% CI: −53.52 to −9.41; p =0.01) was recorded, which significantly correlated not only with reduced trauma and cardiothoracic surgery patients (IRR:2.49; 95% CI: 2.09–2.96; p p = 0.048), and hand disinfectants use (IRR: 0.40; 95% CI: 0.18–0.89; p =0.024). Conclusions: Infection control interventions significantly contributed to the decrease of VAP rate. Constant infection control stewardship has a stable time-effect and guides evidence-based decisions.
