title: Evaluation of the New Centers for Disease Control and Prevention Ventilator-Associated Event Module and Criteria in Critically Ill Children in Greece.
abstract: OBJECTIVE To evaluate the new adult Centers for Disease Control and Prevention (CDC) ventilator-associated event (VAE) module in critically ill children and compare with the traditionally used CDC definition for ventilator-associated pneumonia (VAP). DESIGN Retrospective observational study of mechanically ventilated children in a pediatric intensive care unit in Greece January 1-December 31, 2011. METHODS Assessment of new adult CDC VAE module including 3 definition tiers: ventilator-associated condition (VAC), infection-related VAC, and possible/probable ventilator-associated pneumonia (VAE-VAP); comparison with traditional CDC criteria for clinically defined pneumonia in mechanically ventilated children (PNEU-VAP). We recorded Pediatric Risk of Mortality score at admission (PRISM III), number of ventilator-days, and outcome. RESULTS Among 119 patients with mechanical ventilation (median [range] number of ventilator-days, 7 [1-183]), 19 patients experienced VAC. Criteria for VAE-VAP were fulfilled in 12 of 19 patients with VAC (63%). Children with either VAC or VAE-VAP were on ventilation more days than patients without these conditions (16.5 vs 5 d, P=.0006 and 18 vs 5 d, P<.001, respectively), whereas PRISM-III score was similar between them. Mortality was significant higher in patients with new VAE-VAP definition (50%), but not in patients with VAC (31.6%), than the patients without new VAE-VAP (14%, P=.007) or VAC (15%, P=.1), respectively. No significant association was found between PNEU-VAP and death. Incidences of PNEU-VAP and VAE-VAP were similar, but the agreement was poor. CONCLUSIONS VAE-VAP and PNEU-VAP found similar prevalence in critically ill children but with poor agreement. However, excess of death was significantly associated only with VAE-VAP. Infect Control Hosp Epidemiol 2016:1-5.
authors.affiliation: 1Infectious Diseases Unit,3rd Department of Pediatrics,Aristotle University School of Medicine,Hippokration Hospital,Thessaloniki,Greece.
authors.forename: Elias
authors.initials: E
authors.lastname: Iosifidis
authors.affiliation: 2Pediatric Intensive Care Unit,Hippokration Hospital,Thessaloniki,Greece.
authors.forename: Elpis
authors.initials: E
authors.lastname: Chochliourou
authors.affiliation: 2Pediatric Intensive Care Unit,Hippokration Hospital,Thessaloniki,Greece.
authors.forename: Asimenia
authors.initials: A
authors.lastname: Violaki
authors.affiliation: 1Infectious Diseases Unit,3rd Department of Pediatrics,Aristotle University School of Medicine,Hippokration Hospital,Thessaloniki,Greece.
authors.forename: Elisavet
authors.initials: E
authors.lastname: Chorafa
authors.affiliation: 1Infectious Diseases Unit,3rd Department of Pediatrics,Aristotle University School of Medicine,Hippokration Hospital,Thessaloniki,Greece.
authors.forename: Stavroula
authors.initials: S
authors.lastname: Psachna
authors.affiliation: 1Infectious Diseases Unit,3rd Department of Pediatrics,Aristotle University School of Medicine,Hippokration Hospital,Thessaloniki,Greece.
authors.forename: Afroditi
authors.initials: A
authors.lastname: Roumpou
authors.affiliation: 2Pediatric Intensive Care Unit,Hippokration Hospital,Thessaloniki,Greece.
authors.forename: Maria
authors.initials: M
authors.lastname: Sdougka
authors.affiliation: 1Infectious Diseases Unit,3rd Department of Pediatrics,Aristotle University School of Medicine,Hippokration Hospital,Thessaloniki,Greece.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Roilides
mesh_terms: D000293:Adolescent; D000465:Algorithms; D002487:Centers for Disease Control and Prevention, U.S.; D002648:Child; D002675:Child, Preschool; D016638:Critical Illness; D005260:Female; D006115:Greece / Q000453:epidemiology; D006801:Humans; D007223:Infant; D015278:Intensive Care Units, Pediatric; D008297:Male; D053717:Pneumonia, Ventilator-Associated / Q000175:diagnosis* / Q000453:epidemiology* / Q000401:mortality; D012121:Respiration, Artificial / Q000009:adverse effects*; D012720:Severity of Illness Index; D013308:Streptonigrin; D014481:United States; D055397:Ventilator-Induced Lung Injury / Q000175:diagnosis / Q000401:mortality; D012122:Ventilators, Mechanical / Q000009:adverse effects*
chemical_list: C079133:retrostatin; D013308:Streptonigrin