P250 Incidence, clinical profile and outcomes of ventilator-associated pneumonia in a tertiary hospital

Abstract

Introduction Pneumonia is still the most important nosocomial infection among critically ill patients receiving mechanical ventilation despite advancement in the diagnostic technology available, introduction of new antimicrobials and employment of preventive strategies. Our aim was to prospectively identify the occurrence of ventilator-associated pneumonia in a tertiary hospital as well as to determine its clinical profile and outcomes. Methods A prospective, observational study was performed including 52 patients with VAP in a tertiary hospital. All adult patients admitted who required mechanical ventilation regardless of site of care was included and followed up until successful weaning, discharge or death. Results During the twelve-month study period (May 1, 2009-April 30, 2010), a total of 52 patients (7.6%) developed VAP among the six hundred and eighty six patients who received mechanical ventilation. Most common co-morbid conditions documented were diabetes mellitus and hypertension. Higher APACHE II scores (p =< 0.001), inappropriate antimicrobial use (p = 0.027) and presence of underlying malignancy (p = 0.03) are correlated with mortality. The most common pathogen isolated was Pseudomonas aeruginosa (23%) and carbapenems as the most commonly used antimicrobial. Mortality rate was 38.5%. Non-survivors had numerically longer ICU stay and length of mechanical ventilation(Table presented) Conclusion In our setting, current VAP incidence rate is 7.6% with mortality of 38.5%. This highlights the current magnitude of VAP which should prompt hospital administrators and health care workers to complement rational antibiotic use with non-pharmacologic strategies to at least decrease VAP incidence and alleviate its burden especially in a developing country.