title: [Multicenter survey on ventilator-associated pneumonia prevention in intensive care].
abstract: OBJECTIVE
  Ventilator-associated pneumonia (VAP) is the most common hospital-acquired infection in intensive care unit (ICU). The aim of the study was to evaluate the follow-up of the guidelines for VAP prevention.
  
  
  METHODS
  Retrospective, observational and multicenter study.
  
  
  METHODS
  During one year, all patients with mechanical ventilation over 48 hours were included in the CCLIN-Ouest Network. The demographic characteristics of the patients, the use of specific protocol for VAP prevention and the density of incidence of VAP were recorded. The use of a protocol for preventing VAP (absence, incomplete, complete and care bundle (i.e. complete prevention of VAP with weaning mechanical protocol and sedation protocol)) was collected.
  
  
  RESULTS
  26 ICU with 5742 patients were included. Ten ICU (38%; 2595 patients) had no protocol for VAP prevention, eight ICU (31%; 1821 patients) had an incomplete protocol, five ICU (19%; 561 patients) had a complete protocol and three ICU (12%; 765 patients) had a care bundle. The density of incidence of VAP was 14.8‰ (Interquartile range [IQR]: 10.2-0.1) for no protocol group, 15.6‰ [IQR: 12.6-6.2] for incomplete protocol group, 11.0‰ [IQR: 9.1-14.0] for complete protocol group and 12.9‰ [5-7,7-9,9-12] for care bundle group (P=0.742).
  
  
  CONCLUSIONS
  The compliance to prevention of VAP was poor. Proposals for improving practice are discussed.
authors.affiliation: Pôle réanimations anesthésie Samu/Smur, CHU de Caen, avenue de la Côte-de-Nacre, CS 30001, 14000 Caen, France; EA 4650, université de Caen-Basse-Normandie, Esplanade-de-la-Paix, CS 14032, 14000 Caen, France. Electronic address: fischer-mo@chu-caen.fr.
authors.forename: M-O
authors.initials: MO
authors.lastname: Fischer
authors.forename: N
authors.initials: N
authors.lastname: Garreau
authors.forename: P
authors.initials: P
authors.lastname: Jarno
authors.forename: D
authors.initials: D
authors.lastname: Villers
authors.forename: M
authors.initials: M
authors.lastname: Dufour Trivini
authors.forename: J-L
authors.initials: JL
authors.lastname: Gérard
authors.forename: J-L
authors.initials: JL
authors.lastname: Fellahi
authors.forename: J-L
authors.initials: JL
authors.lastname: Hanouz
authors.forename: J-J
authors.initials: JJ
authors.lastname: Parienti
mesh_terms: D000368:Aged; D002985:Clinical Protocols; D016292:Procedural Sedation; D003422:Critical Care / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D019983:Guideline Adherence; D019538:Health Care Surveys; D006801:Humans; D015994:Incidence; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D053717:Pneumonia, Ventilator-Associated / Q000517:prevention & control*; D011795:Surveys and Questionnaires; D015300:Ventilator Weaning
keywords: Check-list; Guidelines; Pneumopathies acquises sous ventilation mécanique; Preventive; Protocol; Protocole; Prévention; Recommandations; Ventilator-associated pneumonia