Ventilator-Associated Pneumonia and Its Responsible Germs; an Epidemiological Study

<p><strong>Introduction:</strong> Ventilator-associated pneumonia (VAP) is one of the most common hospital infections and a side effect of lengthy stay in intensive care unit (ICU). Considering the ever-changing pattern of common pathogens in infectious diseases and the raise in pr...

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Main Authors: Rama Bozorgmehr, Vanousheh Bahrani, Alireza Fatemi
Format: Article
Language:English
Published: Shahid Beheshti University of Medical Sciences 2016-12-01
Series:Emergency
Subjects:
Online Access:http://journals.sbmu.ac.ir/emergency/article/view/14521
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author Rama Bozorgmehr
Vanousheh Bahrani
Alireza Fatemi
author_facet Rama Bozorgmehr
Vanousheh Bahrani
Alireza Fatemi
author_sort Rama Bozorgmehr
collection DOAJ
description <p><strong>Introduction:</strong> Ventilator-associated pneumonia (VAP) is one of the most common hospital infections and a side effect of lengthy stay in intensive care unit (ICU). Considering the ever-changing pattern of common pathogens in infectious diseases and the raise in prevalence of hospital infections, the present study was designed aiming to determine the prevalence of VAP and its bacterial causes. <strong>Methods:</strong> In this cross-sectional study, the medical profiles of all the patients under mechanical ventilation, who had no symptoms of pneumonia at the time of intubation and developed new infiltration in chest radiography after 48 hours under mechanical ventilation along with at least 2 of the symptoms including fever, hypothermia, leukocytosis, leukopenia, or purulent discharge from the lungs, were evaluated. Demographic data, clinical and laboratory findings, and final outcome of the patients were extracted from the patient’s clinical profile and reported using SPSS version 20 and descriptive statistics.<strong>Results:</strong> 518 patients with the mean age of 62.3 ± 20.8 years were evaluated (50.9% female). Mean time interval between intubation and showing symptoms was 10.89 ± 12.27 days. Purulent discharges (100%), leukocytosis (71.9%), fever (49.1%), hypothermia (12.3%), and leukopenia (8.8%) were the most common clinical and laboratory symptoms and acinetobacter baumannii (31.58%) and klebsiella pneumoniae (29.82%) were the most common germs growing in sputum cultures. 19 (33.3%) cases of pan drug resistance (PDR) and 10 (17.5%) cases of extensive drug resistance (XDR) were seen. Mortality due to VAP was 78.9% and there was no significant correlation between age (p = 0.841), sex (p = 0.473), ICU admission (p = 0.777), duration of hospitalization (p = 0.254), leukocytosis (p = 0.790), leukopenia (p = 0.952), fever (p = 0.171), hypothermia (p = 0.639), type of culture (p = 0.282), and type of antibiotic resistance (p = 0.066) with mortality. <strong>Conclusion:</strong> Prevalence of VAP and its associated mortality were 11% and 78.9%, respectively. The most common symptoms and signs were purulent discharge, leukocytosis, and fever. Acinetobacter baumannii and klebsiella pneumoniae were the most common germs in sputum cultures with 50% resistance to commonly used antibiotics.</p>
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spelling doaj.art-3942d5101c554a2c84927e9a36d914ec2022-12-22T00:59:56ZengShahid Beheshti University of Medical SciencesEmergency2345-45632345-45712016-12-0151e26e2610.22037/emergency.v5i1.145217722Ventilator-Associated Pneumonia and Its Responsible Germs; an Epidemiological StudyRama Bozorgmehr0Vanousheh Bahrani1Alireza Fatemi2Clinical Research Development Unit, Shohadaye Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.Clinical Research Development Unit, Shohadaye Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.<p><strong>Introduction:</strong> Ventilator-associated pneumonia (VAP) is one of the most common hospital infections and a side effect of lengthy stay in intensive care unit (ICU). Considering the ever-changing pattern of common pathogens in infectious diseases and the raise in prevalence of hospital infections, the present study was designed aiming to determine the prevalence of VAP and its bacterial causes. <strong>Methods:</strong> In this cross-sectional study, the medical profiles of all the patients under mechanical ventilation, who had no symptoms of pneumonia at the time of intubation and developed new infiltration in chest radiography after 48 hours under mechanical ventilation along with at least 2 of the symptoms including fever, hypothermia, leukocytosis, leukopenia, or purulent discharge from the lungs, were evaluated. Demographic data, clinical and laboratory findings, and final outcome of the patients were extracted from the patient’s clinical profile and reported using SPSS version 20 and descriptive statistics.<strong>Results:</strong> 518 patients with the mean age of 62.3 ± 20.8 years were evaluated (50.9% female). Mean time interval between intubation and showing symptoms was 10.89 ± 12.27 days. Purulent discharges (100%), leukocytosis (71.9%), fever (49.1%), hypothermia (12.3%), and leukopenia (8.8%) were the most common clinical and laboratory symptoms and acinetobacter baumannii (31.58%) and klebsiella pneumoniae (29.82%) were the most common germs growing in sputum cultures. 19 (33.3%) cases of pan drug resistance (PDR) and 10 (17.5%) cases of extensive drug resistance (XDR) were seen. Mortality due to VAP was 78.9% and there was no significant correlation between age (p = 0.841), sex (p = 0.473), ICU admission (p = 0.777), duration of hospitalization (p = 0.254), leukocytosis (p = 0.790), leukopenia (p = 0.952), fever (p = 0.171), hypothermia (p = 0.639), type of culture (p = 0.282), and type of antibiotic resistance (p = 0.066) with mortality. <strong>Conclusion:</strong> Prevalence of VAP and its associated mortality were 11% and 78.9%, respectively. The most common symptoms and signs were purulent discharge, leukocytosis, and fever. Acinetobacter baumannii and klebsiella pneumoniae were the most common germs in sputum cultures with 50% resistance to commonly used antibiotics.</p>http://journals.sbmu.ac.ir/emergency/article/view/14521Pneumonia, ventilator-associatedcross infectiondrug resistance, microbialintensive care units
spellingShingle Rama Bozorgmehr
Vanousheh Bahrani
Alireza Fatemi
Ventilator-Associated Pneumonia and Its Responsible Germs; an Epidemiological Study
Emergency
Pneumonia, ventilator-associated
cross infection
drug resistance, microbial
intensive care units
title Ventilator-Associated Pneumonia and Its Responsible Germs; an Epidemiological Study
title_full Ventilator-Associated Pneumonia and Its Responsible Germs; an Epidemiological Study
title_fullStr Ventilator-Associated Pneumonia and Its Responsible Germs; an Epidemiological Study
title_full_unstemmed Ventilator-Associated Pneumonia and Its Responsible Germs; an Epidemiological Study
title_short Ventilator-Associated Pneumonia and Its Responsible Germs; an Epidemiological Study
title_sort ventilator associated pneumonia and its responsible germs an epidemiological study
topic Pneumonia, ventilator-associated
cross infection
drug resistance, microbial
intensive care units
url http://journals.sbmu.ac.ir/emergency/article/view/14521
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AT vanoushehbahrani ventilatorassociatedpneumoniaanditsresponsiblegermsanepidemiologicalstudy
AT alirezafatemi ventilatorassociatedpneumoniaanditsresponsiblegermsanepidemiologicalstudy