The prevalence and risk factors of ventilator-associated pneumonia in intensive care units in Hospital Sultanah Bahiyah Kedah Malaysia
Background: Ventilator associated pneumonia (VAP) is the commonest nosocomial infection in intensive care unit (ICU). We conducted a first study to collect local data on prevalence and risk factors of VAP in Hospital Sultanah Bahiyah (HSB), Kedah. Methodology: This prospective cohort surveillance w...
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| Format: | Thesis |
| Language: | English |
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2016
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| Online Access: | http://eprints.usm.my/42076/1/Dr._Loh_Sze_Yee-24_pages.pdf |
| _version_ | 1825834549438840832 |
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| author | Yee, Loh Sze |
| author_facet | Yee, Loh Sze |
| author_sort | Yee, Loh Sze |
| collection | USM |
| description | Background: Ventilator associated pneumonia (VAP) is the commonest nosocomial infection in intensive care unit (ICU). We conducted a first study to collect local data on prevalence and risk factors of VAP in Hospital Sultanah Bahiyah (HSB), Kedah.
Methodology: This prospective cohort surveillance was conducted on patients admitted to an adult medical-surgical ICU of a tertiary hospital from 1st August 2104 to 31st July 2105. VAP was diagnosed using Malaysia Registry of ICU (MRIC) criteria which included clinical manifestation, imaging and investigations.
Results: In total, 297 patients were enrolled in this study. The prevalence of VAP was 22.0%. The most common causative pathogen was Acinetobacter sp. (31.8%). Multivariate analysis using simple logistic regression showed that risk factors for VAP were elderly patients (P=0.02; OR 1.02; 95% CI 1.00, 1.04), increase duration of ventilation (P<0.001; OR 1.49; 95% CI 1.35, 1.63), length of stay in ICU (P<0.001; OR 1.45; 95% CI 1.33, 1.59), length of stay in hospital (P<0.001; OR 1.07; 95% CI 1.04, 1.09), respiratory diseases (P=0.02; OR 2.25; 95% CI 1.17, 4.33), lung malignancy (P<0.001; OR 22.35; 95% CI 6.24, 80.09), previous antibiotic within three months (P=0.02; OR 2.25; 95% CI 1.17, 4.33), tracheostomy (P<0.001; OR 18.42; 95% CI 9.36, 36.23), reintubation (P<0.001; OR 25.69; 95% CI 12.73, 51.82), transportation for remote procedure (P<0.001; OR 20.76; 95% CI 9.65, 44.76), central venous line (CVL) insertion (P=0.04; OR 2.22; 95% CI 1.04, 4.76), continuous sedation (P=0.03; OR 1.85; 95% CI 1.04, 3.26) and without venous thromboprophylaxis (P=0.03; OR 2.05; 95% CI 1.09, 3.87).
Conclusion: The prevalence and risk factors in our study were comparable to national and international data. We identify one new risk factor which is CVL insertion |
| first_indexed | 2024-03-06T15:24:25Z |
| format | Thesis |
| id | usm.eprints-42076 |
| institution | Universiti Sains Malaysia |
| language | English |
| last_indexed | 2024-03-06T15:24:25Z |
| publishDate | 2016 |
| record_format | dspace |
| spelling | usm.eprints-420762019-04-12T05:25:33Z http://eprints.usm.my/42076/ The prevalence and risk factors of ventilator-associated pneumonia in intensive care units in Hospital Sultanah Bahiyah Kedah Malaysia Yee, Loh Sze RD Surgery Background: Ventilator associated pneumonia (VAP) is the commonest nosocomial infection in intensive care unit (ICU). We conducted a first study to collect local data on prevalence and risk factors of VAP in Hospital Sultanah Bahiyah (HSB), Kedah. Methodology: This prospective cohort surveillance was conducted on patients admitted to an adult medical-surgical ICU of a tertiary hospital from 1st August 2104 to 31st July 2105. VAP was diagnosed using Malaysia Registry of ICU (MRIC) criteria which included clinical manifestation, imaging and investigations. Results: In total, 297 patients were enrolled in this study. The prevalence of VAP was 22.0%. The most common causative pathogen was Acinetobacter sp. (31.8%). Multivariate analysis using simple logistic regression showed that risk factors for VAP were elderly patients (P=0.02; OR 1.02; 95% CI 1.00, 1.04), increase duration of ventilation (P<0.001; OR 1.49; 95% CI 1.35, 1.63), length of stay in ICU (P<0.001; OR 1.45; 95% CI 1.33, 1.59), length of stay in hospital (P<0.001; OR 1.07; 95% CI 1.04, 1.09), respiratory diseases (P=0.02; OR 2.25; 95% CI 1.17, 4.33), lung malignancy (P<0.001; OR 22.35; 95% CI 6.24, 80.09), previous antibiotic within three months (P=0.02; OR 2.25; 95% CI 1.17, 4.33), tracheostomy (P<0.001; OR 18.42; 95% CI 9.36, 36.23), reintubation (P<0.001; OR 25.69; 95% CI 12.73, 51.82), transportation for remote procedure (P<0.001; OR 20.76; 95% CI 9.65, 44.76), central venous line (CVL) insertion (P=0.04; OR 2.22; 95% CI 1.04, 4.76), continuous sedation (P=0.03; OR 1.85; 95% CI 1.04, 3.26) and without venous thromboprophylaxis (P=0.03; OR 2.05; 95% CI 1.09, 3.87). Conclusion: The prevalence and risk factors in our study were comparable to national and international data. We identify one new risk factor which is CVL insertion 2016 Thesis NonPeerReviewed application/pdf en http://eprints.usm.my/42076/1/Dr._Loh_Sze_Yee-24_pages.pdf Yee, Loh Sze (2016) The prevalence and risk factors of ventilator-associated pneumonia in intensive care units in Hospital Sultanah Bahiyah Kedah Malaysia. Masters thesis, Universiti Sains Malaysia. |
| spellingShingle | RD Surgery Yee, Loh Sze The prevalence and risk factors of ventilator-associated pneumonia in intensive care units in Hospital Sultanah Bahiyah Kedah Malaysia |
| title | The prevalence and risk factors of ventilator-associated pneumonia in intensive care units in Hospital Sultanah Bahiyah Kedah Malaysia |
| title_full | The prevalence and risk factors of ventilator-associated pneumonia in intensive care units in Hospital Sultanah Bahiyah Kedah Malaysia |
| title_fullStr | The prevalence and risk factors of ventilator-associated pneumonia in intensive care units in Hospital Sultanah Bahiyah Kedah Malaysia |
| title_full_unstemmed | The prevalence and risk factors of ventilator-associated pneumonia in intensive care units in Hospital Sultanah Bahiyah Kedah Malaysia |
| title_short | The prevalence and risk factors of ventilator-associated pneumonia in intensive care units in Hospital Sultanah Bahiyah Kedah Malaysia |
| title_sort | prevalence and risk factors of ventilator associated pneumonia in intensive care units in hospital sultanah bahiyah kedah malaysia |
| topic | RD Surgery |
| url | http://eprints.usm.my/42076/1/Dr._Loh_Sze_Yee-24_pages.pdf |
| work_keys_str_mv | AT yeelohsze theprevalenceandriskfactorsofventilatorassociatedpneumoniainintensivecareunitsinhospitalsultanahbahiyahkedahmalaysia AT yeelohsze prevalenceandriskfactorsofventilatorassociatedpneumoniainintensivecareunitsinhospitalsultanahbahiyahkedahmalaysia |