Risk factors of ventilator-associated pneumonia in intensive care patients at tertiary referral hospital

Abstract

Background: Ventilator-associated pneumonia (VAP) occurs after endotracheal intubation and ventilator for more than 48 hours therefore it is an emerging threat to patient safety. The aim of this study is to determine the incidence and compare the risk factors of ventilator patients diagnosed with ventilator-associated pneumonia and patients with ventilators who are not diagnosed with ventilator-associated pneumonia. Methods: This study used a retrospective observational with a case-control approach. Data was collected from January 2019 to December 2021. The risk factors to be analysed were comorbidities, antibiotic therapy, length of stay in the intensive care unit, duration of ventilator use, and history of surgery. Results: There were 18 patients in the VAP and the control groups met the inclusion and exclusion criteria. The incidence of incidents in 2019 was 3.2 per 1000 ventilator days; in 2020, it was 1.2 per 1000 ventilator days; and in 2021, it was 1.2 per 1000 ventilator days. Comparison test results using Mann-Whitney showed a difference with a p<0.05. Patients with prolonged use of ventilators (p<0.05) and prolonged hospitalization (p<0.05) have a higher risk of developing ventilatorassociated pneumonia. The average VAP occurs on the fourth day on a ventilator. Gram-negative bacteria, Pseudomonas aeruginosa, Acinetobacter baumanii, and Klebsiella pneumoniae cause most bacterial infections Conclusion: There is a high risk of developing VAP in patients with prolonged use of ventilators and extended stays in the intensive care unit of the tertiary referral hospital.