title: Ventilator-Associated Pneumonia and Its Responsible Germs; an Epidemiological Study.
abstract: BACKGROUND
  Ventilator-associated pneumonia (VAP) is one of the most common hospital infections and a side effect of lengthy stay in intensive care unit (ICU). Considering the ever-changing pattern of common pathogens in infectious diseases and the raise in prevalence of hospital infections, the present study was designed aiming to determine the prevalence of VAP and its bacterial causes.
  
  
  METHODS
  In this cross-sectional study, the medical profiles of all the patients under mechanical ventilation, who had no symptoms of pneumonia at the time of intubation and developed new infiltration in chest radiography after 48 hours under mechanical ventilation along with at least 2 of the symptoms including fever, hypothermia, leukocytosis, leukopenia, or purulent discharge from the lungs, were evaluated. Demographic data, clinical and laboratory findings, and final outcome of the patients were extracted from the patient's clinical profile and reported using SPSS version 20 and descriptive statistics.
  
  
  RESULTS
  518 patients with the mean age of 62.3 ± 20.8 years were evaluated (50.9% female). Mean time interval between intubation and showing symptoms was 10.89 ± 12.27 days. Purulent discharges (100%), leukocytosis (71.9%), fever (49.1%), hypothermia (12.3%), and leukopenia (8.8%) were the most common clinical and laboratory symptoms and acinetobacter baumannii (31.58%) and klebsiella pneumoniae (29.82%) were the most common germs growing in sputum cultures. 19 (33.3%) cases of pan drug resistance (PDR) and 10 (17.5%) cases of extensive drug resistance (XDR) were seen. Mortality due to VAP was 78.9% and there was no significant correlation between age (p = 0.841), sex (p = 0.473), ICU admission (p = 0.777), duration of hospitalization (p = 0.254), leukocytosis (p = 0.790), leukopenia (p = 0.952), fever (p = 0.171), hypothermia (p = 0.639), type of culture (p = 0.282), and type of antibiotic resistance (p = 0.066) with mortality.
  
  
  CONCLUSIONS
  Prevalence of VAP and its associated mortality were 11% and 78.9%, respectively. The most common symptoms and signs were purulent discharge, leukocytosis, and fever. Acinetobacter baumannii and klebsiella pneumoniae were the most common germs in sputum cultures with 50% resistance to commonly used antibiotics.
authors.affiliation: Clinical Research Development Unit, Shohadaye Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Rama
authors.initials: R
authors.lastname: Bozorgmehr
authors.affiliation: Clinical Research Development Unit, Shohadaye Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Vanousheh
authors.initials: V
authors.lastname: Bahrani
authors.affiliation: Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Alireza
authors.initials: A
authors.lastname: Fatemi
keywords: Pneumonia; cross infection; drug resistance; intensive care units; microbial; ventilator-associated