Ventilator-associated pneumonias in a cardiothoracic surgery centre postoperative intensive care unit.
Cases of ventilator-associated pneumonia (VAP) were investigated in a cardiothoracic surgery postoperative intensive care unit between 1 January 1999 and 31 December 1999. A total of 1716 patients who had undergone cardiothoracic operations and admitted to the intensive care unit (ICU) were included in the study. Patient- and laboratory-based prospective surveillance of VAP was done along with other hospital-acquired infections. During the study period a total of 26 585 patient-days with 2708 ventilator-days were recorded. Forty-six cases of VAP occurred in 36 of 1716 patients who had undergone cardiothoracic operations (2.09%, 1.3 episodes of pneumonia per patient). The ventilator utilization rate at our institution was 0.10. There were 16.4 VAPs per 1000 ventilation days. Thirty-eight percent of VAP were caused by Gram-negative enteric rods, 34% by Pseudomonas aeruginosa, and 17% by Staphylococcus aureus. VAP was polymicrobial in 9% of cases. No causative micro-organism was identified in 2% of cases. The same bacteria were isolated in both blood and endotracheal aspirate cultures in 10 of 46 pneumonia cases (22%). The crude mortality rate of VAP was calculated as 30%
Simşek
S
S
Dr. Siyami Ersek Cardiovascular and Thoracic Surgery Hospital, Usküdar, Istanbul, Turkey. serapsim@superonline.com
Yurtseven
N
N
Gerçekogalu
H
H
Izgi
F
F
Sohtorik
U
U
Canik
S
S
Ozler
A
A
D003428:Cross Infection / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology* / Q000382:microbiology; D004352:Drug Resistance, Microbial; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D008826:Microbial Sensitivity Tests; D018410:Pneumonia, Bacterial / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology* / Q000382:microbiology; D011182:Postoperative Care; D012121:Respiration, Artificial / Q000009:adverse effects; D019616:Thoracic Surgical Procedures