title: Ventilator-associated pneumonia rates in critical care units in 3 Arabian Gulf countries: A 6-year surveillance study.
abstract: Data estimating the rates of ventilator-associated pneumonia (VAP) in critical patients in Gulf Cooperation Council (GCC) countries are very limited. The aim of this study was to estimate VAP rates in GCC hospitals and to compare rates with published reports of the U.S. National Healthcare Safety Network (NHSN) and International Nosocomial Infection Control Consortium (INICC).
  
  
  
  VAP rates and ventilator utilization between 2008 and 2013 were calculated from aggregate VAP surveillance data using NHSN methodology pooled from 6 hospitals in 3 GCC countries: Saudi Arabia, Oman, and Bahrain. The standardized infection ratios of VAP in GCC hospitals were compared with published reports of the NHSN and INICC.
  
  
  
  A total of 368 VAP events were diagnosed during a 6-year period covering 76,749 ventilator days and 134,994 patient days. The overall VAP rate was 4.8 per 1,000 ventilator days (95% confidence interval, 4.3-5.3), with an overall ventilator utilization of 0.57. The VAP rates showed a wide variability between different types of intensive care units (ICUs) and were decreasing over time. After adjusting for the differences in ICU type, the risk of VAP in GCC hospitals was 217% higher than NHSN hospitals and 69% lower than INICC hospitals.
  
  
  
  The risk of VAP in ICU patients in GCC countries is higher than pooled U.S. VAP rates but lower than pooled rates from developing countries participating in the INICC.
authors.affiliation: Infection Prevention and Control Department, King Abdulaziz Medical City, Riyadh, Saudi Arabia; Gulf Cooperation Council States and World Health Organization Collaborating Center for Infection Prevention & Control, Saudi Arabia; Community Medicine Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
authors.forename: Aiman
authors.initials: A
authors.lastname: El-Saed
authors.affiliation: Gulf Cooperation Council States and World Health Organization Collaborating Center for Infection Prevention & Control, Saudi Arabia; Infection Prevention and Control, Royal Hospital, Muscat, Oman.
authors.forename: Amina
authors.initials: A
authors.lastname: Al-Jardani
authors.affiliation: King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; Infection Prevention and Control, King Abdulaziz Medical City, Jeddah, Saudi Arabia.
authors.forename: Abdulhakeem
authors.initials: A
authors.lastname: Althaqafi
authors.affiliation: Infection Prevention and Control, Salmaniya Medical Complex, Manama, Bahrain.
authors.forename: Huda
authors.initials: H
authors.lastname: Alansari
authors.affiliation: Gulf Cooperation Council States and World Health Organization Collaborating Center for Infection Prevention & Control, Saudi Arabia; Infection Prevention and Control, Salmaniya Medical Complex, Manama, Bahrain.
authors.forename: Jameela
authors.initials: J
authors.lastname: Alsalman
authors.affiliation: Infection Prevention and Control, Royal Hospital, Muscat, Oman.
authors.forename: Zaina
authors.initials: Z
authors.lastname: Al Maskari
authors.affiliation: Infection Prevention and Control, King Abdulaziz Hospital, Al hassa, Saudi Arabia.
authors.forename: Ayman
authors.initials: A
authors.lastname: El Gammal
authors.affiliation: Infection Prevention and Control, Imam Abdulrahman bin Faisal Hospital, Dammam, Saudi Arabia.
authors.forename: Wafa
authors.initials: W
authors.lastname: Al Nasser
authors.affiliation: Gulf Cooperation Council States and World Health Organization Collaborating Center for Infection Prevention & Control, Saudi Arabia; Infection Prevention and Control, Royal Hospital, Muscat, Oman.
authors.forename: Seif S
authors.initials: SS
authors.lastname: Al-Abri
authors.affiliation: Infection Prevention and Control Department, King Abdulaziz Medical City, Riyadh, Saudi Arabia; Gulf Cooperation Council States and World Health Organization Collaborating Center for Infection Prevention & Control, Saudi Arabia; King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia. Electronic address: balkhyh@hotmail.com.
authors.forename: Hanan H
authors.initials: HH
authors.lastname: Balkhy
mesh_terms: D001445:Bahrain / Q000453:epidemiology; D003422:Critical Care; D062665:Epidemiological Monitoring; D006801:Humans; D015994:Incidence; D009850:Oman / Q000453:epidemiology; D053717:Pneumonia, Ventilator-Associated / Q000453:epidemiology*; D012529:Saudi Arabia / Q000453:epidemiology
keywords: Bahrain; Benchmarking; Oman; Saudi Arabia; Ventilator-associated pneumonia; health care; infection control; surveillance