Analysis of epidemiology and risk factors for mortality in ventilator-associated pneumonia attacks in intensive care unit patients

Authors: AYŞE BUT, MELTEM ARZU YETKİN, DİLEK KANYILMAZ, HALİDE ASLANER, ALİYE BAŞTUĞ, ADALET AYPAK, PINAR ÖNGÜRÜ, ESRAGÜL AKINCI, NEVZAT MEHMET MUTLU, HURREM BODUR

Abstract: Background/aim: The aim of this study was to investigate the epidemiologic characteristics, the causative microorganisms and their antimicrobial susceptibility patterns, and the prognostic risk factors for mortality in critically ill patients with ventilator-associated pneumonia (VAP). Materials and methods: In this retrospective observational study, all the critically ill patients with VAP hospitalized in a medical/surgical intensive care unit (ICU) between January 2010 and June 2015 were evaluated. Patients' demographic features and microbiological data were reviewed. Results: A total of 417 patients were clinically diagnosed with VAP; 51.1% of them were male and the average age was found as 69.9 ± 15.9 years. VAP was detected at approximately 25.0 ± 18.0 days of ICU stay and 17.9 ± 12.6 days after intubation. Acinetobacter baumannii (69.5%) was isolated as the most frequent VAP agent, and the most effective antibiotic was colistin. The crude mortality rate was detected as 39.8% among the patients. The presence of dyspnea at admission, coronary heart disease as a comorbidity, unconsciousness at admission, steroid usage, and prolonged hospital stay were observed as independent risk factors in multivariate analysis (P < 0.01). Conclusion: According to the etiological microorganisms and antimicrobial susceptibility patterns, colistin was found to be the most reliable antibiotic for empirical antimicrobial therapy.

Keywords: Ventilator-associated pneumonia, intensive care units, risk factors

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