Analysis of risk factors for ventilator-associated pneumonia in a multidisciplinary intensive care unit

Abstract

A prospective study was conducted to determine the incidence, risk factors and pathogens of ventilator-associated pneumonia (VAP) in 198 patients requiring mechanical ventilation for more than 48 hours. VAP occurred in 67 (33.8%) patients. Risk factors associated with VAP were admission APACHE II score > 20 (odds ratio [OR] 4.77, 95% confidence interval [CI] 2.04-11.27, P < 0.001), mechanical ventilation > 10 days (OR 44.4, 95% CI 2.16-26.7, P < 0.0001), ICU length of stay > 10 days (OR 9.4, 95% CI 3.55-25.65, P < 0.0001), and admission PaO2/FiO2 ratio < 200 mmHg (OR 3.4, 95% CI 1.00-11.41, P < 0.05). Logistic regression analysis showed a relationship between VAP and length of stay in ICU, duration of fever and presence of catheter-related infection. The pathogens isolated were predominantly gram-negative bacteria (83.2%), with a high proportion of Acinetobacter spp. (35%) resistant to commonly used antimicrobial agents. The mortality rate was not influenced by VAP.