Differences in incidence and outcome of ventilator-associated pneumonia in surgical and medical ICUs in a tertiary hospital in China

Xiaochun Song, Yongming Chen, Xiuhua Li
Clinical Respiratory Journal 2014, 8 (3): 262-8

BACKGROUND: Ventilator-associated pneumonia (VAP) is a common hospital-acquired infection in intensive care units (ICUs). The incidences and outcomes of VAP in a medical ICU (MICU) and a surgical ICU (SICU) were compared.

METHODS: A total of 329 patients admitted to the MICU or SICU who were mechanically ventilated for ≥48 h were included.

RESULTS: The incidence of VAP in the MICU was 25%, with 29.7 cases per 1000 ventilator days, and the incidence of VAP in the SICU was 26.7%, with 27.4 cases per 1000 ventilator days. In the MICU patients without VAP spent 6.0 days on the ventilator and those with VAP spent 8.5 days (P < 0.001); the length of stay (LOS) in the ICU was 9.0 days vs 14.0 days for patients without and with VAP, respectively (P < 0.001). The mortality in the MICU was 34.1% for patients without VAP vs 55.8% for those with VAP (P = 0.012), and 30-day mortalities were 31.8% and 41.9%, respectively (P = 0.228); 60-day mortalities were 34.1% and 53.5%, respectively (P = 0.024). In the SICU, patients without and with VAP were ventilated for 5.0 and 10.0 days, respectively (P < 0.001). The ICU LOS was 7.0 days for patients without VAP vs 15.0 days for patients with VAP (P < 0.001). The mortality rates of VAP-free and VAP-positive patients in the SICU were 38.9% and 54.5%, respectively (P = 0.076). The 30-day mortalities were 36.3% and 43.2% (P = 0.424), and 60-day mortalities were 38.9% and 50.0%, for patients without and with VAP, respectively (P = 0.061).

CONCLUSIONS: These data indicate that VAP prolonged time on ventilator and ICU stay in our institute and increased the mortality in the MICU. There were no differences in incidence of or mortality from VAP in the MICU and SICU.


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