title: Ventilator-associated pneumonia in intensive care units in Hubei Province, China: a multicentre prospective cohort survey.
abstract: A multicentre prospective cohort study was performed in 17 intensive care units (ICUs) in tertiary care hospitals in Hubei Province, China. Ventilator-associated pneumonia (VAP) was defined according to modified criteria from the published literature. Among 4155 ventilated patients, the crude incidence and incidence rate of VAP were 20.9% and 28.9 cases per 1000 ventilator-days. Multivariate analysis using logistic regression revealed risk factors including male sex [risk ratio (RR): 1.5; P<0.001], coma (RR: 2.1; P<0.001), chronic obstructive pulmonary disease (RR: 1.4; P<0.001), infections at other sites (RR: 1.6; P=0.001), serious disease predating the onset of VAP (RR: 1.6; P<0.001) and interventions including antacid treatment (RR: 1.4; P<0.001), antimicrobial treatment (RR: 5.1; P<0.001), bronchoscopy (RR: 1.5; P=0.041) and tracheostomy (RR: 1.4; P=0.014). The most frequently isolated causative pathogens were Pseudomonas aeruginosa and Acinetobacter baumannii. Of all Staphylococcus aureus isolates, 45.7% were meticillin resistant. Rates, risk factors and causal pathogens of VAP in ICUs in Hubei differ from those reported from developed countries. These data show the need for more effective infection control interventions in Hubei, China.
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, China.
authors.forename: Duo-shuang
authors.initials: DS
authors.lastname: Xie
authors.forename: Wei
authors.initials: W
authors.lastname: Xiong
authors.forename: Rui-ping
authors.initials: RP
authors.lastname: Lai
authors.forename: Li
authors.initials: L
authors.lastname: Liu
authors.forename: Xiu-min
authors.initials: XM
authors.lastname: Gan
authors.forename: Xiao-hui
authors.initials: XH
authors.lastname: Wang
authors.forename: Min
authors.initials: M
authors.lastname: Wang
authors.forename: Yuan-xia
authors.initials: YX
authors.lastname: Lou
authors.forename: Xiang-yun
authors.initials: XY
authors.lastname: Fu
authors.forename: Hui-fang
authors.initials: HF
authors.lastname: Wang
authors.forename: Hao
authors.initials: H
authors.lastname: Xiang
authors.forename: Yi-hua
authors.initials: YH
authors.lastname: Xu
authors.forename: Shao-fa
authors.initials: SF
authors.lastname: Nie
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001419:Bacteria / Q000145:classification / Q000187:drug effects / Q000302:isolation & purification*; D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007362:Intensive Care Units; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D018410:Pneumonia, Bacterial / Q000453:epidemiology* / Q000382:microbiology; D053717:Pneumonia, Ventilator-Associated / Q000453:epidemiology* / Q000382:microbiology; D011446:Prospective Studies; D012307:Risk Factors; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents