Ventilator-associated pneumonia in a tertiary care hospital in India: incidence and risk factors

  • Noyal Mariya Joseph Department of Microbiology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry
  • Sujatha Sistla Department of Microbiology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry
  • Tarun Kumar Dutta Department of Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry
  • Ashok Shankar Badhe Department of Anaesthesiology and Critical care, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry
  • Subhash Chandra Parija Department of Microbiology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry
Keywords: Ventilator-Associated Pneumonia, risk factors, Emergency intubation, tracheostomy

Abstract

Background: Knowledge of the incidence of ventilator-associated pneumonia (VAP) and its associated risk factors is imperative for the development and use of more effective preventive measures.

Methodology: We performed a prospective study over a period of 15 months to determine the incidence and the risk factors for development of VAP in critically ill adult patients admitted in different intensive care units (ICUs) of Jawaharlal Institute of Post-graduate Medical Education and Research (JIPMER), a tertiary care hospital in Pondicherry, India.

Results: The incidence of VAP was 30.67 and 15.87 per 1,000 ventilator days in the two different ICUs. In our study 58.3% of the cases were late-onset VAP, while 41.7% were early-onset VAP. Univariate analysis indicated that the following were significantly associated with VAP: impaired consciousness, tracheostomy, re-intubation, emergency intubation, and nasogastric tube. Emergency intubation and intravenous sedatives were found to be the specific risk factors for early onset VAP, while tracheostomy and re-intubation were the independent predictors of late-onset VAP by multivariate logistic regression analysis.

Conclusions: Knowledge of these risk factors may be useful in implementing simple and effective preventive measures including non-invasive ventilation, precaution during emergency intubation, minimizing the occurrence of reintubation, avoidance of tracheostomy as far as possible, and minimization of sedation.

Published
2009-11-05
How to Cite
1.
Joseph NM, Sistla S, Dutta TK, Badhe AS, Parija SC (2009) Ventilator-associated pneumonia in a tertiary care hospital in India: incidence and risk factors. J Infect Dev Ctries 3:771-777. doi: 10.3855/jidc.396
Section
Original Articles