Prevalence of ventilator-associated pneumonia (VAP) in patients admitted to intensive care units in Saudi Arabia: a systematic review

Abstract

Background & objective: This study aimed to systematically assess the prevalence of ventilator-associated pneumonia (VAP) among intensive care unit (ICU) patients in Saudi Arabia and to evaluate the impact of preventive interventions. Methodology: A systematic search of PubMed, Scopus, Web of Science, and regional databases identified 364 studies (2000–2023). After duplicate removal and screening, four studies (n = 4247 patients; 64.7% male) met the inclusion criteria. Data extraction and quality assessment were performed using Rayyan QCRI and PRISMA guidelines. Results: VAP prevalence in Saudi ICUs varied widely, ranging from 2.2% to 35.4%, with a pooled prevalence of 12%. Implementation of structured preventive measures, particularly ventilator care bundles, was consistently associated with reduced VAP incidence, shorter durations of mechanical ventilation, decreased hospital stays, and improved patient outcomes. Despite these improvements, differences in study design and reporting continue to limit direct comparisons across centers. Conclusion: VAP remains a significant concern in Saudi Arabian ICUs, with prevalence rates higher than some international benchmarks. Preventive strategies, especially care bundles, are effective but require ongoing adaptation to local contexts. Further research should focus on standardizing surveillance, evaluating long-term intervention effectiveness, and identifying region-specific risk factors to optimize patient care and resource utilization. Abbreviations: ICU: intensive care unit, VAP: ventilator-associated pneumonia,.