Incidence and costs of ventilator-associated pneumonia in the adult intensive care unit of a tertiary referral hospital in Mexico

Sosa-Hernández, Óscar; Matías-Téllez, Bernadine; Estrada-Hernández, Abril; Cureño-Díaz, Mónica Alethia; Bello–López, Juan Manuel

doi:10.1016/j.ajic.2019.02.031

Cited by 32 publications

(39 citation statements)

References 37 publications

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Section: Introductionmentioning

confidence: 99%

“…Ventilator-associated pneumonia (VAP) is pneumonia that occurs within 48 hr after the intubation of intensive care patients [1][2][3][4]. Because the VAP rate depends on a number of factors, such as age, days of mechanical ventilation, and chronic diseases, the real incidence of VAP is difficult to determine [1], but in the literature [1,[3][4][5], it is considered to be high. In studies conducted in Egypt, Iran, China, the United States of America, and Turkey, the VAP rate per 1,000 mechanical ventilator days was found to be 70.3, 21.08, 29.5 (13.4 medical/surgical ICU and 23.7 medical ICU), and 31.2, respectively [6][7][8].…”

Section: Introductionmentioning

confidence: 99%

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The effectiveness of training given to nurses for reducing ventilator-associated pneumonia in intensive care patients

Cengiz

Kanan

2019

DHS

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Purpose The aim of this study it to determine the effect of training intensive care unit (ICU) nurses in reducing ventilator-associated pneumonia (VAP). Materials and methods A quasi-experimental (single group, pre-test–post-test) model was used. The study was conducted in 2015, in nine adult ICUs in Istanbul, where we observed the VAP rate and trained study group nurses. Sixty nurses were given two VAP training sessions (averaging 45 min each) at intervals of 6 months. Forty-nine nurses were in the control group. Data were collected with an Introductory Information Form, a VAP Information Test, and an Application Status of VAP Preventive/Reducing Initiatives Form. The incidences of VAP in 2014 and 2015 were also compared. Frequencies, percentages, means, standard deviations, t-tests, Wilcoxon tests, and χ2 tests were used to evaluate the data. The values of p less than .05 were considered significant. Results The mean-total-knowledge score increased significantly in the study group. The application of preventive/reducing initiatives also increased significantly in the study group, but in the last measurement, the difference between the groups was not statistically significant. The incidences of VAP decreased significantly in the study group. Conclusion The study showed that the VAP training given to intensive care nurses increased their knowledge level and decreased the incidence of VAP in their ICUs.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The effectiveness of training given to nurses for reducing ventilator-associated pneumonia in intensive care patients

Cengiz

Kanan

2019

DHS

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“…En la atención de los casos de infecciones asociadas a la atención de la salud (IAAS), uno de los recursos que generan mayores costos son los antimicrobianos. Sosa et al (2019) calcularon los costos de las neumonías asociadas a la ventilación (NAV) en la unidad de cuidados intensivos de adultos y se observó que 16% del gasto fue por el uso de antimicrobianos, con un total de 83 056,83 dólares, y un gasto promedio por caso de 1 730,37 dólares; cuando las NAV eran causadas por bacterias multirresistentes, el riesgo el riesgo de rebasar el costo de la atención aumentaba nueve veces ( 9 ).…”

Section: Discussionunclassified

Resultados del Programa de Uso Racional de Antimicrobianos en un hospital de México, 2013-2018

Sosa-Hernández

Vázquez-Zamora

Gutiérrez-Muñoz

et al. 2020

Revista Panamericana De Salud Pública

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Objetivo. Describir los resultados del Programa de Uso Racional de Antimicrobianos en el Hospital Juárez de México. Métodos. Se diseñó un estudio de tipo observacional, transversal, retrospectivo y descriptivo. Se analizó el consumo de antimicrobianos de enero de 2013 a diciembre de 2018 a través del cálculo de la dosis diaria definida (DDD); para el análisis de costos se realizó un cálculo de costeo tradicional. Resultados. En el grupo de los carbapenémicos, es notable la reducción en el consumo de imipenem/cilastina: se pasó de una DDD en el 2013 de 2,3 a 0,7 en el 2018, con una reducción de 70%. En cambio, en los otros dos fármacos, se ha observado un incremento. En meropenem se registró de 2% (de 2,4 en 2013 a 2,5 en 2018); en el consumo de ertapenem el incremento es de 75% (de 1 en 2013 a 1,8 en 2018). En total, el gasto de antimicrobianos durante 2013 fue de $930 556,46, mientras que en 2018 fue de $856 079,10, con una diferencia de 8%, lo que equivale a $74 905,61 del gasto total (los valores se expresan en dólares estadounidenses). Conclusiones. Se necesita evaluar de manera constante los programas para el uso racional de antimicrobianos, mediante el monitoreo del consumo y el gasto derivado.

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“…A recent meta-analysis showed that patients with VAP had signi cantly longer ICU lengths of stay (mean = 6.10 days; 95% CI, 5.32-6.87) [14]; A study showed that patients who developed VAP incurred ≥ $10,019 in additional hospital costs. Methods to effectively prevent and treat VAP remain a medical challenge [15].…”

Section: Introductionmentioning

confidence: 99%

Incidence Rates, Risk Factors, and Mortality Rates of Ventilator-Associated Pneumonia: A meta-analysis.

Wang

Jia

et al. 2020

Preprint

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Background: Ventilator-associated pneumonia (VAP) is the second most common nosocomial infection in Intensive care units (ICUs) and is associated with the significant utilization of health-care resources. However, the incidence rates, risk factors and mortality rates of VAP are controversial.Methods: The Web of Science, EMBASE, PubMed and Cochrane Library databases through May 2020 were independently searched by two researchers to collect all relevant studies. Data including incidence rates, risk factors and mortality rates of VAP were extracted for the meta-analysis.Results: 24 studies, including 10 retrospective studies and 14 prospective studies on VAP were included in our analysis. In the meta-analysis, we found that the VAP rate was 20/1000 ventilator-days (95% confidence interval (CI) 17–22%). The data demonstrated that trauma (odds ratio (OR) 1.51; 95% CI 1.21-1.88), steroids use (OR 1.51; 95% CI 1.25-1.82), enteral feeding (OR 3.40; 95% CI 2.56-4.52), nasogastric tube placement (OR 2.96; 95% CI 1.75-5.00), tracheostomy (OR 3.65; 95% CI 1.93-6.90), reintubation (OR 6.08; 95% CI 4.62-8.00), central vascular catheter (CVC) placement (OR 3.83; 95% CI 2.55-5.77), blood transfusion(OR 1.75; 95% CI 1.16-2.64), H2 blockers use (OR 2.28; 95% CI 1.27-4.07) and Chronic obstructive pulmonary disease(COPD)(OR 1.24; 95% CI 1.07-1.44) were risk factors of VAP. When patients developed VAP, duration of ICU stay (OR 11.09; 95% CI 7.50-14.68) and duration of mechanical ventilation (MV) (OR 12.96; 95% CI 10.42-15.51) were significantly increased. What’s more, VAP was associated with an increased risk of mortality (OR 1.38; 95% CI 1.04-1.83).ConclusionsThis study may contribute to the development of improved infection control strategies for high-risk patients. Additional studies are needed in the future to clarify the incidence rates, risk factors and mortality rates of VAP.

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Incidence and costs of ventilator-associated pneumonia in the adult intensive care unit of a tertiary referral hospital in Mexico

Cited by 32 publications

References 37 publications

The effectiveness of training given to nurses for reducing ventilator-associated pneumonia in intensive care patients

The effectiveness of training given to nurses for reducing ventilator-associated pneumonia in intensive care patients

Resultados del Programa de Uso Racional de Antimicrobianos en un hospital de México, 2013-2018

Incidence Rates, Risk Factors, and Mortality Rates of Ventilator-Associated Pneumonia: A meta-analysis.

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