Ventilator-Associated Pneumonia: Incidence, Risk Factors and Outcome in Paediatric Intensive Care Units at Cairo University Hospital

Abstract

Identification of risk factors and outcome of VAP in PICUs may help in reducing the incidence and improving patients' outcomes. The incidence of VAP in this study was relatively high. The most prominent risk factors for occurrence of VAP were MOSF, prior antibiotic use for > 48 h before MV, reintubation, coma and age. Proper use of antibiotics before MV in PICUs is essential. Also, adequate training of nurses and strict supervision of infection control protocols are crucial. Lack of a gold standard for the diagnosis of VAP and difficulty in sampling procedures were among the study limitations.

Comparative study of incidence, risk factors, etiological agents and outcome of early and late ventilator associated pneumonia in paediatric intensive care unit at a tertiary care centre

“…Incidence of VAP is differs greatly based on setting and location in critically ill children in PICU. Our study showed an incidence of 33.7% in paediatric VAP patients which is comparable with the incidence of 31% reported by Galal Y et al 23 However, Chiru D et al have reported an incidence of 43.13% in all children aged 0-18 years.24 In a 30-month prospective study in a PICU in Saudi Arabia the VAP incidence was 10.3%. 5 Admissions of male patients in the study was more as compared to females contributing in higher incidence of VAP in males.…”

“…Our findings were similar to that of Galal YS et al wherein neurological cause was seen in 39.4% cases ventilated. 23 On the contrary, in the study done by Hamid M et al, the most common indication of ventilation was respiratory failure in 72% cases, neuromuscular blockade and paralysis in 24% cases. 25 Chiru D et al reported acute Re-intubation was required in 70% of the patients who developed VAP and it was a significant risk factor for development of Late VAP.…”

“…Overall mortality in paediatric patients having VAP as reported by Galal Y et al was 68.2%. 23 Mortality rates were also higher in VAP patients in a study done by Patri MF et in Italy. 33 In the study conducted by Payal J et al the mortality was rate was high up to 52%.…”

Evaluation of Microorganisms Causing Ventilator-Associated Pneumonia in a Pediatric Intensive Care Unit

“…The rate of adherence to hand hygiene procedures was 64.4±3.1%. At diagnosis, the mean leukocyte count was 15,240±6,500 cells/mm 3 , and the median procalcitonin and CRP levels were 3.16 (0.05-54.33) ng/mL and 56.9 (3.17-369) mg/ A single microorganism was isolated from 86.4% of patients (n=38), whereas two microorganisms were isolated from 13.6% (n=6). Overall, 96% (n=48) of the isolated strains were gram-negative and 4% (n=2) gram-positive.…”

“…Prior antibiotic use, application of invasive procedures, use of drugs affecting gastric empty-ing and pH, aspiration of gastric contents, prolonged mechanical ventilation, patient position, severity of underlying illness; central nervous system disorders, frequent changes of endotracheal tubes, and presence of coma, pneumonia, and acute respiratory distress syndrome are among the factors predicting VAP development [3]. VAP is an important cause of morbidity and mortality in patients in the ICU [4].…”