title: Epidemiology and Outcome of Ventilator-Associated Pneumonia in a Heterogeneous ICU Population in Qatar.
abstract: Objective. The purpose of this study is to collect data on epidemiology, microbiology, and outcome of VAP in our ICUs for reevaluation of the therapeutic strategies. Methods. This retrospective study involved all adult patients, 15 years of age or older, diagnosed with VAP in multidisciplinary ICUs at Hamad General Hospital between January 2010 and December 2012. Results. A total of 106 patients were enrolled. The mean incidence of VAP was 5.0 per 1000 ventilator-days. It was predominant among younger age group (<60 years), male patients (80.2%), and trauma ICU admissions (49.0%). The most common comorbidity was hypertension (34%) and polytrauma (36.8%) was the most frequent admission diagnosis. 30-day mortality was 23.6% and it was significantly higher in ≥60 years age group, female gender, patients with diabetes mellitus, hypertension, chronic respiratory disease, ≥1 comorbidity, and poor functional status, smokers, medical and surgical ICU admissions, and patients with previous stay in medical/surgical wards, inappropriate empirical therapy, and admission diagnosis of respiratory failure. Gram-negative bacilli were the most frequent respiratory specimen isolates, Pseudomonas spp. being the most common. Majority of our Acinetobacter isolates were multidrug resistant. Conclusion. The incidence of VAP in our ICUs was low. Higher mortality rates were observed in certain subgroup of patients. Resistance to commonly used antimicrobials is likely to require reevaluation of the therapeutic strategies at our institution.
authors.affiliation: Department of Medical ICU, Hamad General Hospital, P.O. Box 3050, Doha, Qatar.
authors.forename: Husain Shabbir
authors.identifier: 0000-0002-2104-3080
authors.initials: HS
authors.lastname: Ali
authors.affiliation: Department of Internal Medicine, Hamad General Hospital, P.O. Box 3050, Doha, Qatar.
authors.forename: Fahmi Yousef
authors.initials: FY
authors.lastname: Khan
authors.affiliation: Department of Medical ICU, Hamad General Hospital, P.O. Box 3050, Doha, Qatar.
authors.forename: Saibu
authors.initials: S
authors.lastname: George
authors.affiliation: Department of Surgical ICU, Hamad General Hospital, P.O. Box 3050, Doha, Qatar.
authors.forename: Nissar
authors.initials: N
authors.lastname: Shaikh
authors.affiliation: Department of Infectious Disease, Hamad General Hospital, P.O. Box 3050, Doha, Qatar.
authors.forename: Jameela
authors.initials: J
authors.lastname: Al-Ajmi
mesh_terms: D000150:Acinetobacter; D000293:Adolescent; D000328:Adult; D000368:Aged; D000890:Anti-Infective Agents / Q000737:chemistry; D015897:Comorbidity; D003422:Critical Care / Q000379:methods*; D003625:Data Collection; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D006801:Humans; D015994:Incidence; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D010397:Penicillanic Acid / Q000031:analogs & derivatives / Q000737:chemistry; D010878:Piperacillin / Q000737:chemistry; D053717:Pneumonia, Ventilator-Associated / Q000453:epidemiology* / Q000628:therapy*; D011549:Pseudomonas; D011780:Qatar / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D000078142:Tazobactam; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000890:Anti-Infective Agents; D010397:Penicillanic Acid; D000078142:Tazobactam; D010878:Piperacillin