Analysis of risk factors for ventilator-associated pneumonia in a multidisciplinary intensive care unit.
A prospective study was conducted to determine the incidence, risk factors and pathogens of ventilator-associated pneumonia (VAP) in 198 patients requiring mechanical ventilation for more than 48 hours. VAP occurred in 67 (33.8%) patients. Risk factors associated with VAP were admission APACHE II score >20 (odds ratio [OR] 4.77, 95% confidence interval [CI] 2.04-11.27, P<0.001), mechanical ventilation > 10 days (OR 44.4, 95% CI 2.16-26.7, P< 0.0001), ICU length of stay >10 days (OR 9.4, 95% CI 3.55-25.65, P< 0.0001), and admission PaO2/FiO2 ratio <200mmHg (OR 3.4, 95% CI 1.00-11.41, P<0.05). Logistic regression analysis showed a relationship between VAP and length of stay in ICU, duration of fever and presence of catheter-related infection. The pathogens isolated were predominantly gram-negative bacteria (83.2%), with a high proportion of Acinetobacter spp. (35%) resistant to commonly used antimicrobial agents. The mortality rate was not influenced by VAP.
Sofianou
D C
DC
Department of Medical Microbiology, Aristotle University of Thessaloniki, Greece.
Constandinidis
T C
TC
Yannacou
M
M
Anastasiou
H
H
Sofianos
E
E
D002408:Catheters, Indwelling / Q000009:adverse effects; D005334:Fever; D006801:Humans; D015994:Incidence; D007239:Infections / Q000209:etiology; D007362:Intensive Care Units; D007902:Length of Stay; D018410:Pneumonia, Bacterial / Q000453:epidemiology / Q000209:etiology* / Q000382:microbiology; D011446:Prospective Studies; D012044:Regression Analysis; D012121:Respiration, Artificial / Q000009:adverse effects*; D012307:Risk Factors; D016019:Survival Analysis; D013997:Time Factors; D012122:Ventilators, Mechanical / Q000009:adverse effects