The prevalence and risk factors of ventilator-associated pneumonia in intensive care units in Hospital Sultanah Bahiyah Kedah Malaysia
Loading...
Date
2016
Authors
Yee, Loh Sze
Journal Title
Journal ISSN
Volume Title
Publisher
Pusat Pengajian Sains Perubatan, Universiti Sains Malaysia
Abstract
Background: Ventilator associated pneumonia (VAP) is the commonest nosocomial infection in intensive care unit (ICU). We conducted a first study to collect local data on prevalence and risk factors of VAP in Hospital Sultanah Bahiyah (HSB), Kedah.
Methodology: This prospective cohort surveillance was conducted on patients admitted to an adult medical-surgical ICU of a tertiary hospital from 1st August 2104 to 31st July 2105. VAP was diagnosed using Malaysia Registry of ICU (MRIC) criteria which included clinical manifestation, imaging and investigations.
Results: In total, 297 patients were enrolled in this study. The prevalence of VAP was 22.0%. The most common causative pathogen was Acinetobacter sp. (31.8%). Multivariate analysis using simple logistic regression showed that risk factors for VAP were elderly patients (P=0.02; OR 1.02; 95% CI 1.00, 1.04), increase duration of ventilation (P<0.001; OR 1.49; 95% CI 1.35, 1.63), length of stay in ICU (P<0.001; OR 1.45; 95% CI 1.33, 1.59), length of stay in hospital (P<0.001; OR 1.07; 95% CI 1.04, 1.09), respiratory diseases (P=0.02; OR 2.25; 95% CI 1.17, 4.33), lung malignancy (P<0.001; OR 22.35; 95% CI 6.24, 80.09), previous antibiotic within three months (P=0.02; OR 2.25; 95% CI 1.17, 4.33), tracheostomy (P<0.001; OR 18.42; 95% CI 9.36, 36.23), reintubation (P<0.001; OR 25.69; 95% CI 12.73, 51.82), transportation for remote procedure (P<0.001; OR 20.76; 95% CI 9.65, 44.76), central venous line (CVL) insertion (P=0.04; OR 2.22; 95% CI 1.04, 4.76), continuous sedation (P=0.03; OR 1.85; 95% CI 1.04, 3.26) and without venous thromboprophylaxis (P=0.03; OR 2.05; 95% CI 1.09, 3.87).
Conclusion: The prevalence and risk factors in our study were comparable to national and international data. We identify one new risk factor which is CVL insertion
Description
Keywords
Pneumonia, Ventilator-Associated