Ventilator-associated Pneumonia: Epidemiology and Prognostic Factors of 30-day Mortality.

Ventilator-associated Pneumonia: Epidemiology and Prognostic Factors of 30-day Mortality. Jpn J Infect Dis. 2014 Dec 24; Authors: Inchai J, Pothirat C, Liwsrisakun C, Deesomchok A, Kositsakulchai W, Chalermpanchai N Abstract A retrospective cohort study was conducted in the medical intensive care unit of University Hospital to describe the epidemiology of Ventilator-associated pneumonia (VAP) and identify the prognostic factors of 30-day mortality. A total of 621 patients with a diagnosis of VAP between January 2005 and December 2011 were included. The overall 30-day mortality rate was 44.4%. The major causative pathogens were Acinetobacter baumannii (54.3%), followed by Pseudomonas aeruginosa (35.2%) and Methicillin-resistant Staphylococcus aureus (MRSA) (15.1%). Most A.baumannii (90.2%) comprised drug-resistant strains. The prognostic factors were co-morbid malignancy (HR=1.60, 95% CI 1.02-2.42, P=0.040), septic shock (HR=2.51, 95% CI 1.60-4.00, P<0.001), SAPS II > 45 (HR=1.62, 95% CI 1.03-2.56, P=0.041), SOFA score > 5 (HR=3.40, 95% CI 2.00-5.81, P<0.001) and delayed inappropriate empirical antibiotic treatment (HR=2.23, 95% CI 1.12-4.45, P=0.022). VAP was associated with high mortality. The major causative pathogen was drug-resistant A.baumannii. Therefore, surveillance for VAP among mechanically ventilated patients for early detection will lead to early treatment, improving the patient outcomes. The guidelines for pr...
Source: Japanese Journal of Infectious Diseases - Category: Infectious Diseases Authors: Tags: Jpn J Infect Dis Source Type: research