title: Incidence and risk factors of ventilator associated pneumonia in a tertiary care hospital.
abstract: BACKGROUND
  Ventilator associated pneumonia (VAP) is a type of nosocomial pneumonia associated with increased morbidity and mortality. Knowledge about the incidence and risk factors is necessary to implement preventive measures to reduce mortality in these patients.
  
  
  METHODS
  A prospective study was conducted at a tertiary care teaching hospital for a period of 20 months from November 2009 to July 2011. Patients who were on mechanical ventilation (MV) for more than 48 hours were monitored at frequent intervals for development of VAP using clinical and microbiological criteria until discharge or death.
  
  
  RESULTS
  Of the 76 patients, 18 (23.7%) developed VAP during their ICU stay. The incidence of VAP was 53.25 per 1,000 ventilator days. About 94% of VAP cases occurred within the first week of MV. Early-onset and late-onset VAP was observed in 72.2% and 27.8%, respectively. Univariate analysis showed chronic lung failure, H2 blockers usage, and supine head position were significant risk factors for VAP. Logistic regression revealed supine head position as an independent risk factor for VAP.
  
  
  CONCLUSIONS
  VAP occurred in a sizeable number of patients on MV. Chronic lung failure, H2 blockers usage, and supine head position were the risk factors associated with VAP. Awareness about these risk factors can be used to inform simple and effective preventive measures.
authors.affiliation: Department of Microbiology, Mahatma Gandhi Medical College and Research Institute, Pondicherry, India.
authors.forename: Mv Pravin
authors.initials: MP
authors.lastname: Charles
authors.forename: Joshy M
authors.initials: JM
authors.lastname: Easow
authors.forename: Noyal M
authors.initials: NM
authors.lastname: Joseph
authors.forename: M
authors.initials: M
authors.lastname: Ravishankar
authors.forename: Shailesh
authors.initials: S
authors.lastname: Kumar
authors.forename: Sivaraman
authors.initials: S
authors.lastname: Umadevi
keywords: VAP; incidence; risk factors