The incidence of ventilator-associated pneumonia (VAP) in a tertiary-care center: Comparison between pre- and post-VAP prevention bundle

Osman, Sara; Talhi, Yousef M. Al; Al-Dabbagh, Mona; Baksh, Mohamed; Osman, Mohamed; Azzam, Maha

doi:10.1016/j.jiph.2019.09.015

Cited by 40 publications

(37 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Surprisingly, no infections were recorded based on Gram-positive isolates, indicating that probably, the antibiotic regime used as a rule of thumb in the ICU and the cleaning protocols diminishes the possibility of their growth. Similar results were recently reported in the pediatric intensive care unit of King Abdulaziz Medical City, Saudi Arabia, during the evaluation of the VAP prevention bundle [ 27 ]. The prevention bundle included elevating the bed’s head to avoid aspiration of oropharynx secretions, providing mouth hygiene to reduce oropharynx colonization, keeping ventilator circuits clean and dry to reduce device contamination, hand washing before and after touching the patients, using a cuffed endotracheal tube to avoid aspiration of oropharynx secretions, sedation holiday for deeply sedated patients every morning, and using anti-reflex prophylaxis.…”

Section: Discussionsupporting

confidence: 88%

“…The prevention bundle included elevating the bed’s head to avoid aspiration of oropharynx secretions, providing mouth hygiene to reduce oropharynx colonization, keeping ventilator circuits clean and dry to reduce device contamination, hand washing before and after touching the patients, using a cuffed endotracheal tube to avoid aspiration of oropharynx secretions, sedation holiday for deeply sedated patients every morning, and using anti-reflex prophylaxis. This resulted in the omission of Gram-positive bacteria-mediated VAP [ 27 ]. Other studies at Egyptian Nasser Institute’s ICU [ 28 ], Saudi Arabian King Abdul-Aziz Medical City in Riyadh [ 29 ], and ICUs of different hospitals in an urban town in India [ 22 ] showed a higher rate of Gram-negative bacteria than Gram-positive ones.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Microbial etiologies of ventilator-associated pneumonia (VAP) in intensive care unit of Beni-Suef University’s Hospital

Maebed

Gaber

Bakeer

et al. 2021

Beni-Suef Univ J Basic Appl Sci

View full text Add to dashboard Cite

Background Ventilator-associated pneumonia (VAP) is a major health problem for people intubated in intensive care units (ICUs), leading to increased mortality rates, hospital stay, and treatment costs. In the present study, the core pathogens causing VAP in Beni-Suef University's Hospital, Egypt, was investigated over a study period of 2 years (2017–2019). Results Of a total of 213 patients subjected to mechanical ventilation, 60 have developed VAP during their stay in the ICU. The mortality rate reached 41.7% among VAP patients. Sixty bacteria were isolated from an endotracheal aspirate of hospitalized patients. The different isolates were cultured followed by running biochemical tests, sensitivity assays, and automated VITEK®2 System analysis. Unexpectedly, all the isolates were Gram-negative bacteria. Klebsiella pneumoniae were the main pathogen encountered (27/60 isolates) followed by Acientobacter baumannnii (7/60) and other microorganisms belonging to the genera Moraxella, Escherichia, and Pseudomonas (11/60). Antibiotic sensitivity testing was performed via the VITEK®2 System using up to 16 different antibiotics representing 8 different antibiotic classes and subclasses (aminoglycosides, carbapenems, fluoroquinolones, penicillin/β-lactamase inhibitor, extended-spectrum cephalosporins, aminopenicillins, aminopenicillins/β-lactamase inhibitor, folic acid synthesis inhibitor). Majority of the isolates (28/60) showed a remarkable extensive drug resistance (XDR) pattern, while 15 isolates were multi-drug resistant (MDR) and only 6 were pan-drug resistant (PDR) with regard to antibiotics under evaluation. Conclusion The association of VAP with multi-drug-resistant bacteria is alarming, and rapid management is crucial. Identification of core pathogens is essential for identifying the most appropriate technique for infection control.

show abstract

Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Microbial etiologies of ventilator-associated pneumonia (VAP) in intensive care unit of Beni-Suef University’s Hospital

Maebed

Gaber

Bakeer

et al. 2021

Beni-Suef Univ J Basic Appl Sci

View full text Add to dashboard Cite

show abstract

“…Some reports have shown benefit from preventative measures such as ventilator bundles, particularly at teaching hospitals, whereas in other settings the findings have been less supportive of preventative strategies in reducing in VAP rates. 31,32 Teaching hospitals may be the most fertile ground for studies of interventions aimed at reducing the risk for VAP. Any study of a technique to reduce VAP should account for teaching status and should include a non-teaching institution to see if there is a differential effect.…”

Section: Discussionmentioning

confidence: 99%

Making Ventilator Associated Pneumonia Rate a Meaningful Quality Marker

Keneally

Peterson

Benjamin

et al. 2020

J Intensive Care Med

View full text Add to dashboard Cite

Introduction: Ventilator associated pneumonia (VAP) rate has been tracked as a comparable quality measure but there is significant variation between types of ICUs. We sought to understand variability and improve its utility as a marker of quality. Methods: The National Trauma Database was surveyed to identify risk factors for VAP. Logistic regression, χ2, Student’s T-test or Mann-Whitney U test were used. Results: Risk factors associated with developing VAP were: injury severity score (ISS) (OR 1.03, 95% CI 1.03 -1.04), prehospital assisted respiration (PHAR) (OR 1.10, 1.03 -1.17), thoracic injuries (OR 2.28, 1.69-3.08), diabetes (OR 1.32, 1.20 -1.46), male gender (OR 1.38, 1.28 -1.60), care at a teaching hospital (OR 1.40, 1.29 -1.47) and unplanned intubation (OR 2.76, 2.52-3.03). Discussion: ISS, PHAR, diabetes, male gender, care at a teaching hospital and unplanned intubation are risk factors for the development of VAP. These factors should be accounted for in order to make VAP an effective quality marker.

show abstract

“…Mortalitas VAP mencapai 4-72%, lebih tinggi dibandingkan dengan infeksi nosokomial lainnya. 2,3,4 VAP adalah pneumonia yang terjadi dalam waktu 48-72 jam setelah pemasangan intubasi endotrakeal. 2,5 VAP yang terjadi dalam waktu kurang dari 96 jam sejak pemasangan intubasi endotrakeal digolongkan ke dalam VAP awitan dini (early onset VAP) dan bila terjadi di atas 96 jam digolongkan dalam awitan lambat (late onset VAP).…”

Section: Pendahuluanunclassified

Profil Dan Pola Kepekaan Bakteri Penyebab Ventilator Associated Pneumonia Di RSUP H. Adam Malik Medan

Wahyuni¹,

Amelia²,

Fadine³

2020

Jurnal Pandu Husada

View full text Add to dashboard Cite

Ventilator-associated pneumonia (VAP) merupakan infeksi nosokomial yang banyak terjadi di intensive care unit dan masih menjadi masalah di bidang kesehatan. Hal ini menyebabkan tingkat mortalitas dan morbiditas yang tinggi, biaya pengobatan yang besar, serta munculnya bakteri resisten terhadap banyak antibiotik. Tujuan penelitian ini adalah untuk mengetahui profil dan pola kepekaan antimikroba pada bakteri penyebab VAP di RSUP H Adam Malik Medan. Penelitian prosfektif terhadap pasien suspek VAP dilakukan dari bulan Agustus hingga November 2017. Sebanyak 22 sampel sputum aspirat endotrakeal diperiksa. Pemeriksaan mikroskopik menggunakan metode pewarnaan Gram dari kultur yang tumbuh. Identifikasi dan uji kepekaan bakteri menggunakan alat VITEC 2 Compact (bioMérieux ® ). Total 28 isolat bakteri telah diidentifikasi, terdiri dari 26 basil gram negatif (92,9%) and dua bakteri Gram positif. Bakteri yang paling banyak adalah Acinetobacter baumannii (39,3%), diikuti Pseudomonas aeruginosa (21,4%), dan Escherichia coli (14,8%).Terdapat 19 isolat bakteri patogen Multi Drug Resistant (ESBL,Carbapenemase resistant, MRSA). Basil Gram negatif masih peka terhadap amikasin mencapai 76%, dan hampir seluruhnya resisten terhadap sefalosporin generasi 3. Semua isolat Acinetobacter baumannii resisten terhadap meropenem, sedangkan Escherichia coli dan Klebsiella pneumonia masih sensitif seluruhnya (100%). Acinetobacter baumannii merupakan penyebab utama VAP. Resistensi antibiotik mengalami peningkatan karena munculnya bakteri patogen multidrug resistance.

show abstract

The incidence of ventilator-associated pneumonia (VAP) in a tertiary-care center: Comparison between pre- and post-VAP prevention bundle

Cited by 40 publications

References 25 publications

Microbial etiologies of ventilator-associated pneumonia (VAP) in intensive care unit of Beni-Suef University’s Hospital

Microbial etiologies of ventilator-associated pneumonia (VAP) in intensive care unit of Beni-Suef University’s Hospital

Making Ventilator Associated Pneumonia Rate a Meaningful Quality Marker

Profil Dan Pola Kepekaan Bakteri Penyebab Ventilator Associated Pneumonia Di RSUP H. Adam Malik Medan

Contact Info

Product

Resources

About