Epidemiology and outcomes of ventilator-associated pneumonia in northern Brazil: an analytical descriptive prospective cohort study

BMC Infectious Diseases

Valério Monteiro-Neto¹  Cinara R A V Monteiro⁴  Patrícia M S Figueiredo⁴  Bianca Callegari²  Sílvio G Monteiro³  Marília M Resende⁴ 

[1] Pró-Reitoria de Pós-Graduação, Pesquisa e Extensão, Universidade CEUMA, Rua Josué Montello No.1, CEP: 65.075-120, São Luís, MA, Brazil;Instituto de Ciências da Saúde, Universidade Federal do Pará, Belém, Pará, Brazil;Departamento de Ciências Biológicas, Universidade Federal do Maranhão, São Luís, Maranhão, Brazil;Laboratório de Microbiologia, Universidade CEUMA, São Luís, Maranhão, Brazil

关键词: Epidemiology;    Bacterial multiresistance;    Invasive mechanical ventilation;    Ventilator-associated pneumonia;   

Others  :  1171004
DOI  :  10.1186/1471-2334-13-119

 received in 2012-09-10, accepted in 2013-03-01,  发布年份 2013

【 摘 要 】

Background

Ventilator-associated pneumonia (VAP) is considered the most common nosocomial infection in the intensive care unit (ICU), but its features are not fully known in many hospitals in Brazil. We identified clinical and epidemiological aspects associated with VAP in an intensive care unit (ICU) in a general public hospital in northern Brazil and performed an analytical descriptive prospective cohort study.

Methods

We analyzed data from thirty-three patients who developed VAP while in the ICU. Clinical and epidemiological data of patients were obtained and tracheal secretions were submitted to culture. Microbial isolates were identified and evaluated for resistance against antimicrobial agents by using the automated Vitek 2 system.

Results

The frequency of VAP was 26.2% in patients submitted to invasive mechanical ventilation for at least 48 hours, and death occurred in 78.8% of cases. Only the presence of comorbidity showed a significant association (P = 0.029) with death. The most commonly found bacteria were Pseudomonas aeruginosa, Acinetobacter spp., and Enterobacteriaceae. We also found a frequency of 54.5% of multiresistant bacteria associated with VAP, and previous antibiotic therapy was used in 97% of patients.

Conclusions

VAP in our ICU presented with a high frequency and was mainly caused by multiresistant bacteria. Implementation of rational protocols for the use of antibacterial agents and rapid delivery of culture and susceptibility test results are essential. This may help decrease VAP-related mortality rates by multiresistant bacteria in the ICU.

【 授权许可】

   
2013 Resende et al; licensee BioMed Central Ltd.

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