Skip to main content Skip to main navigation menu Skip to site footer

Risk factors of ventilator-associated pneumonia in intensive care patients at tertiary referral hospital

  • Ayu Permatasari Tribuana Tungga Dewi ,
  • Ni Made Mertaniasih ,
  • Bambang Pujo Semedi ,
  • Lindawati Alimsardjono ,
  • Pepy Dwi Endraswari ,


Abstract

Link of Video Abstract: https://youtu.be/YEQ3ICJPmxA

 

Background: Ventilator-associated pneumonia (VAP) occurs after endotracheal intubation and ventilator for more than 48 hours therefore it is an emerging threat to patient safety. The aim of this study is to determine the incidence and compare the risk factors of ventilator patients diagnosed with ventilator-associated pneumonia and patients with ventilators who are not diagnosed with ventilator-associated pneumonia.

Methods: This study used a retrospective observational with a case-control approach. Data was collected from January 2019 to December 2021. The risk factors to be analysed were comorbidities, antibiotic therapy, length of stay in the intensive care unit, duration of ventilator use, and history of surgery.

Results: There were 18 patients in the VAP and the control groups met the inclusion and exclusion criteria. The incidence of incidents in 2019 was 3.2 per 1000 ventilator days; in 2020, it was 1.2 per 1000 ventilator days; and in 2021, it was 1.2 per 1000 ventilator days. Comparison test results using Mann-Whitney showed a difference with a p<0.05. Patients with prolonged use of ventilators (p<0.05) and prolonged hospitalization (p<0.05) have a higher risk of developing ventilator-associated pneumonia. The average VAP occurs on the fourth day on a ventilator. Gram-negative bacteria, Pseudomonas aeruginosa, Acinetobacter baumanii, and Klebsiella pneumoniae cause most bacterial infections

Conclusion: There is a high risk of developing VAP in patients with prolonged use of ventilators and extended stays in the intensive care unit of the Tertiary Referral Hospital.

Keywords: ventilator-associated pneumonia intensive care unit

References

  1. Papazian L, Klompas M, Luyt CE. Ventilator-associated pneumonia in adults: a narrative review. Intensive Care Med. 2020;46(5):888-906.
  2. Deng J, Li F, Zhang N, Zhong Y. Prevention and treatment of ventilator-associated pneumonia in COVID-19. Front Pharmacol. 2022;13:945892.
  3. Aguiar-Alves F, Le HN, Tran VG, et al. Antivirulence bispecific monoclonal antibody-mediated protection against Pseudomonas aeruginosa ventilator-associated pneumonia in a rabbit model. Antimicrob Agents Chemother. 2022;66(2):e0202221.
  4. Hellyer TP, McAuley DF, Walsh TS, et al. Biomarker-guided antibiotic stewardship in suspected ventilator-associated pneumonia (VAPrapid2): a randomised controlled trial and process evaluation. Lancet Respir Med. 2020;8(2):182-191.
  5. Timsit JF, Esaied W, Neuville M, Bouadma L, Mourvllier B. Update on ventilator-associated pneumonia. F1000Res. 2017;6:2061.
  6. Al-Omari B, McMeekin P, Allen AJ, et al. Systematic review of studies investigating ventilator associated pneumonia diagnostics in intensive care. BMC Pulm Med. 2021;21(1):196.
  7. Kharel S, Bist A, Mishra SK. Ventilator-associated pneumonia among ICU patients in WHO Southeast Asian region: A systematic review. PLoS One. 2021;16(3):e0247832.
  8. Patil HV, Patil VC. Incidence, bacteriology, and clinical outcome of ventilator-associated pneumonia at tertiary care hospital. J Nat Sci Biol Med. 2017;8(1):46-55.
  9. Hurley JC. World-wide variation in incidence of Acinetobacter associated ventilator associated pneumonia: a meta-regression. BMC Infect Dis. 2016;16(1):577.
  10. Yao J, Guan S, Liu Z, Li X, Zhou Q. Changes in immune indicators and bacteriologic profile were associated with patients with ventilator-associated pneumonia. Medicine (Baltimore). 2020;99(16):e19716.
  11. Bramardipa AAB, Sukrama IDM, Budayanti NNS. Bacterial pattern and its susceptibility toward antibiotic on burn infection in Burn Unit Sanglah General Hospital. Bali Medical Journal. 2019;8(1):328-333.
  12. Arayasukawat P, So-Ngern A, Reechaipichitkul W, et al. Microorganisms and clinical outcomes of early- and late-onset ventilator-associated pneumonia at Srinagarind Hospital, a tertiary center in Northeastern Thailand. BMC Pulm Med. 2021;21(1):47.
  13. Sun YC, Wang CY, Wang HL, Yuan Y, Lu JH, Zhong L. Probiotic in the prevention of ventilator-associated pneumonia in critically ill patients: evidence from meta-analysis and trial sequential analysis of randomized clinical trials. BMC Pulm Med. 2022;22(1):168.
  14. Wedari NLPH, Sukrama IDM, Budayanti NNS, Sindhughosa DA, Prabawa IPY, Manuaba IBAP. One Health concept and role of animal reservoir in avian influenza: a literature review. Bali Medical Journal. 2021;10(2):515-520.
  15. Khilnani GC, Dubey D, Hadda V, et al. Predictors and microbiology of ventilator-associated pneumonia among patients with exacerbation of chronic obstructive pulmonary disease. Lung India. 2019;36(6):506-511.
  16. Hayati Z, Jamil KF, Azhari A, Mahdani W, Karmil TF, Yossadania A, Dahril, Habibie YA. Outcome of urinary tract infection caused by Extended Spectrum Beta-Lactamase (ESBL) producing Escherichia coli and Klebsiella pneumoniae in Dr Zainoel Abidin General Hospital Aceh. Bali Medical Journal. 2021;10(2): 544-548.
  17. Fan Y, Gao F, Wu Y, Zhang J, Zhu M, Xiong L. Does ventilator-associated event surveillance detect ventilator-associated pneumonia in intensive care units? A systematic review and meta-analysis. Crit Care. 2016;20(1):338.
  18. Le Pape M, Besnard C, Acatrinei C, et al. Clinical impact of ventilator-associated pneumonia in patients with the acute respiratory distress syndrome: a retrospective cohort study. Ann Intensive Care. 2022;12(1):24.
  19. Mustikaningtyas MH, Semedi BP, Kuntaman. Bacterial and sensitivity pattern of pathogens causing ventilator-associated pneumonia in intensive care unit. Biomorfologi. 2022;32(1);22-28.
  20. Arthur LE, Kizor RS, Selim AG, van Driel ML, Seoane L. Antibiotics for ventilator-associated pneumonia. Cochrane Database Syst Rev. 2016;10(10):CD004267.
  21. Emonet S, Lazarevic V, Leemann Refondini C, et al. Identification of respiratory microbiota markers in ventilator-associated pneumonia. Intensive Care Med. 2019;45(8):1082-1092.
  22. Fernández-Barat L, López-Aladid R, Torres A. Reconsidering ventilator-associated pneumonia from a new dimension of the lung microbiome. EBioMedicine. 2020;60:102995.
  23. Luyt CE, Hékimian G, Bonnet I, et al. Usefulness of point-of-care multiplex PCR to rapidly identify pathogens responsible for ventilator-associated pneumonia and their resistance to antibiotics: an observational study. Crit Care. 2020;24(1):378.

How to Cite

Dewi, A. P. T. T. ., Mertaniasih, N. M., Semedi, B. P. ., Alimsardjono, L. ., & Endraswari, P. D. . (2023). Risk factors of ventilator-associated pneumonia in intensive care patients at tertiary referral hospital. Bali Medical Journal, 12(2), 1441–1445. https://doi.org/10.15562/bmj.v12i2.4446
ACM ACS APA ABNT Chicago Harvard IEEE MLA Turabian Vancouver
Download Citation
Endnote/Zotero/Mendeley (RIS) BibTeX

HTML
0

Total
0

Share

Search Panel

Ayu Permatasari Tribuana Tungga Dewi
Google Scholar
Pubmed
BMJ Journal

Ni Made Mertaniasih
Google Scholar
Pubmed
BMJ Journal

Bambang Pujo Semedi
Google Scholar
Pubmed
BMJ Journal

Lindawati Alimsardjono
Google Scholar
Pubmed
BMJ Journal

Pepy Dwi Endraswari
Google Scholar
Pubmed
BMJ Journal