title: [Reducing the incidence of ventilator-associated pneumonia following heart surgery: 13-year experience of epidemiologic surveillance in a teaching hospital].
abstract: OBJECTIVE
  To report the results of 13 years worth of epidemiologic surveillance of ventilator-associated pneumonia (VAP) following heart surgery and the main interventions applied in order to reduce VAP incidence.
  
  
  METHODS
  This is a retrospective and descriptive study of active epidemiologic surveillance of VAP. National diagnostic criteria were used. Interventions associated with a decrease in VAlP incidence in adults who underwent heart surgery are described.
  
  
  RESULTS
  A significant and sustained reduction was observed in the rate of VAP; being 56.7 per 1,000 ventilator-days in 1998 vs 4.7 per 1,000 ventilator-days in 2010 (p < 0.001). The strongest reduction was observed following 2003 (34.4 to 14.8 per 1,000 ventilator-days in 2004, p < 0.001). The interventions with greatest impact were the implementation of an early-weaning protocol, the introduction of trained nurses to perform the mechanical ventilator equipment management and the routine use of alcohol-based hand rubs.
  
  
  CONCLUSIONS
  Epidemiologic surveillance associated with the establishment of a multifactorial intervention program applied in collaboration with the attending team, have demonstrated a significant reduction of VAP incidence after heart surgery.
authors.affiliation: Departamento de Medicina Interna, Hospital Clínico Pontificia Universidad Católica de Chile, Santiago, Chile. majenjo@puc.cl
authors.forename: M Cristina
authors.initials: MC
authors.lastname: Ajenjo
authors.forename: Alejandra
authors.initials: A
authors.lastname: Zambrano
authors.forename: María I
authors.initials: MI
authors.lastname: Eugenin
authors.forename: Pablo
authors.initials: P
authors.lastname: Achurra
authors.forename: Ricardo
authors.initials: R
authors.lastname: Zalaquett
authors.forename: Manuel J
authors.initials: MJ
authors.lastname: Irarrázaval
authors.forename: Gabriela
authors.initials: G
authors.lastname: De la Cerda
authors.forename: Paula
authors.initials: P
authors.lastname: Fernández
authors.forename: Miriam
authors.initials: M
authors.lastname: Barañao
authors.forename: Patricia
authors.initials: P
authors.lastname: Fuentealba
authors.forename: Marcela
authors.initials: M
authors.lastname: Ferrés
authors.forename: Patricia
authors.initials: P
authors.lastname: García
authors.forename: Carlos
authors.initials: C
authors.lastname: Pérez
authors.forename: Jaime
authors.initials: J
authors.lastname: Labarca
mesh_terms: D000328:Adult; D006348:Cardiac Surgical Procedures / Q000009:adverse effects / Q000706:statistics & numerical data; D002677:Chile / Q000453:epidemiology; D062665:Epidemiological Monitoring; D006784:Hospitals, Teaching / Q000592:standards / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D017053:Infection Control / Q000379:methods*; D007362:Intensive Care Units; D053717:Pneumonia, Ventilator-Associated / Q000453:epidemiology / Q000517:prevention & control*; D012189:Retrospective Studies