Risk Factors of Pneumonia Associated with Mechanical Ventilation
Abstract
:1. Introduction
2. Materials and Methods
3. Results
4. Discussion
5. Conclusions
- Patients with acute respiratory failure, multi-organ trauma, fractures, or hemorrhage/hemorrhagic shock are groups with a predisposition to the occurrence of VAP.
- Particular attention should be paid to patients with comorbid COPD, obesity, diabetes, or alcoholism as high-risk groups for VAP.
Author Contributions
Funding
Conflicts of Interest
Abbreviations
CDC | Centers for Disease Control |
ECDC | European Centre for Disease Prevention and Control |
ETT | Endotracheal Tube |
HAP | Hospital-Acquired Pneumonia |
ICU | Intensive Care Unit |
VAP | Ventilator-Associated Pneumonia |
LOS | length of stay |
References
- Torres, A.; Niederman, M.S.; Chastre, J.; Ewig, S.; Fernandez-Vandellos, P.; Hanberger, H.; Kollef, M.; Bassi, G.I.; Luna, C.M.; Martin-Loeches, I.; et al. International ERS/ESICM/ESCMID/ALAT guidelines for the management of hospital-acquired pneumonia and ventilator-associated pneumonia: Guidelines for the management of hospital-acquired pneumonia (HAP)/ventilator-associated pneumonia (VAP) of the European Respiratory Society (ERS), European Society of Intensive Care Medicine (ESICM), European Society of Clinical Microbiology and Infectious Diseases (ESCMID) and Asociación Latinoamericana del Tórax (ALAT). Eur. Respiry J. 2017, 50, 1700582. [Google Scholar]
- Klompas, M.; Branson, R.; Eichenwald, E.C.; Greene, L.R.; Howell, M.D.; Lee, G.; Magill, S.S.; Maragakis, L.L.; Priebe, G.P.; Speck, K.; et al. Strategies to prevent ventilator-associated pneumonia in acute care hospitals: 2014 update. Inf. Control Hosp. Epidemiol. 2014, 35, S133–S154. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- European Center for Disease Prevention and Control. Surveillance of Healthcare—Associated Infections in Europe, 2007; ECDC: Stockholm, Sweden, 2012; pp. 43–71. Available online: http://ecdc.europa.eu/en/publications/Publications/120215SURHAI2007.pdf (accessed on 30 June 2017).
- European Center for Disease Prevention and Control. Antimicrobial Resistance and Healthcare-Associated Infection. In Annual Epidemiological Report 2014; ECDC: Stockholm, Sweden, 2015; Available online: http://ecdc.europa.eu/en/publications/publications/antimicrobial-resistance-annual-epidemiological-report.pdf (accessed on 17 January 2020).
- Beth, A. Ventilator-Associated Pneumonia Risk Factors and Prevention, Crit. Care Nurse 2007, 27, 32–39. [Google Scholar]
- Wałaszek, M.; Kosiarska, A.; Gniadek, A.; Kołpa, M.; Wolak, Z.; Dobroś, W.; Siadek, J. The risk factors for hospital—Acquired pneumonia in the Intensive Care Unit. Przeglad Epidemiol. 2016, 70, 15–20. [Google Scholar]
- Hamishehkar, H.; Vahidinezhad, M.; Mashayekhi, S.O. Education alone is not enough in ventilator associated pneumonia care bundle compliance. J. Res. Pharm. Pract. 2014, 3, 51–55. [Google Scholar]
- Kołpa, M.; Wałaszek, M.; Gniadek, A.; Wolak, Z.; Dobroś, W. Incidence, Microbiological Profile and Risk Factors of Healthcare-Associated Infections in Intensive Care Units: A 10 Year Observation in a Provincial Hospital in Southern Poland. Int. J. Environ. Res. Public Health 2018, 15, 112. [Google Scholar] [CrossRef] [Green Version]
- Lahoorpour, F.; Delpisheh, A.; Afkhamzadeh, A. Risk factors for the acquisition of ventilator-associated pneumonia in adult Intensive Care Units. Pak. J. Medican Sci. 2013, 29, 1105–1107. [Google Scholar] [CrossRef]
- Aykac, K.; Ozsurekci, Y.; Basaranoglu, S. Future Directions and Molecular Basis of Ventilator Associated Pneumonia. Can. Respiry J. 2017, 2, 2614602. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Keyt, H.; Faverio, P.; Restrepo, M.I. Prevention of ventilator-associated pneumonia in the intensive care unit: A review of the clinically relevant recent advancements. Indian J. Med. Res. 2014, 139, 814–821. [Google Scholar]
- CDC/NHSN Surveillance Definition of Healthcare—Associated Infection and Criteria for Specific Types of Infections in the Acute Care Setting. Available online: www.cdc.gov (accessed on 17 January 2020).
- European Center for Disease Prevention and Control. Point Prevalence Survey of Healthcare—Associated Infections and Antimicrobial Use in European Acute Care Hospitals—Protocol, version 4.3; ECDC: Stockholm, Sweden, 2012; Available online: http://www.ecdc.europa.eu/en/publications/publications/0512-ted-pps-hai-antimicrobialuse-protocol.pdf.website (accessed on 17 January 2020).
- European Centre for Disease Prevention and Control. European Surveillance of Healthcare Associated Infections in Intensive Care Units—Hai-Net ICU Protocol, version 1.02; ECDC: Stockholm, Sweden, 2015. [Google Scholar]
- Bobik, P.; Siemiątkowski, A. Ventilator-associated pneumonia and other infections. Pneumonologia i Alergologia Polska 2014, 82, 472–480. [Google Scholar] [CrossRef]
- Karpel, E. Zapalenie płuc związane ze stosowaniem wentylacji mechanicznej (VAP-ventilator associated pneumonia)—Ocena postępu intensywnej terapii. Zakażenia 2009, 5, 25–33. [Google Scholar]
- Szreter, T. Odrespiratorowe zapalenie płuc—Profilaktyka, leczenie. Zakażenia 2009, 3, 74–79. [Google Scholar]
- Kubisz, A.; Kulig, J.; Szczepanik, A.M.; Solecki, R. Elevated blood glucose level as a risk factor of hospital-acquired pneumonia among patients treated in the intensiv care unit (ICU). Prz. Lekarski 2011, 68, 136–139. [Google Scholar]
- Rosenthal, V.D.; Al-Abdely, H.M.; El-Kholy, A.A.; Khawaja, S.A.A.; Leblebicioglu, H.; Mehta, Y.; Rai, V.; Hung, N.V.; Kanj, S.S.; Salama, M.F.; et al. International Nosocomial Infection Control Consortium report, data summary of 50 countries for 2010-2015: Device-associated module. Am. J. Infect. Control 2016, 44, 1495–1504. [Google Scholar] [CrossRef] [PubMed]
- Dudeck, M.A.; Weiner, L.M.; Allen-Bridson, K.; Malpiedi, P.J.; Peterson, K.D.; Pollock, D.; Sievert, D.M.; Edwards, J.R. National Healthcare Safety Network (NHSN) report, data summary for 2012, Device-associated module. Am. J. Infect. Control 2013, 41, 1148–1166. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Rosenthal, V.D.; Maki, D.G.; Salomato, R.; Moreno, C.A.; Mehta, Y.; Higuera, F.; Cuellar, L.E.; Arikan, O.A.; Abouqal, R.; Leblebicioglu, H.; et al. Device-associated nosocomial infections in 55 intensive care units of 8 developing countries. Ann. Int. Med. 2006, 145, 582–591. [Google Scholar] [CrossRef] [PubMed]
- Ranjan, R.; Chaudhty, U.; Chaudhty, D.; Ranjan, K.P. Ventilator-associated pneumonia in a tertiary care intensive care unit: Analysis of incidence, risk factors and mortality. Indian J. Crit. Care Med. 2014, 18, 200–204. [Google Scholar] [PubMed]
- Hryniewicz, W.; Ozorowski, T. Rekomendacje diagnostyki, terapii i profilaktyki antybiotykowej zakażeń w szpitalu. Wydawnictwo Narodowy Instytut Leków Warszawa 2015, 12, 59–61. [Google Scholar]
- Karaoglan, H.; Yalcin, A.N.; Cengiz, M.; Ramazanoglu, A.; Ogunc, D.; Hakan, R. Cost analysis of ventilator-associated pneumonia in Turkish medical-surgical intensive care units. Le Infez. Med. 2010, 18, 248–255. [Google Scholar]
- Pirożyński, M.; Pirożyńska, E.; Fedyniak, D. Hospital acquired pneumonia. Borgis Postępy Nauk Med. 2009, 8, 602–609. [Google Scholar]
Comorbidities | VAP | |||||
---|---|---|---|---|---|---|
Yes | No | p | ||||
n | % | n | % | |||
Diabetes | Yes | 161 | 9 | 548 | 29 | 0.016 |
No | 265 | 14 | 1181 | 48 | ||
Obesity | Yes | 145 | 8 | 145 | 8 | <0.001 |
No | 281 | 15 | 1301 | 69 | ||
Alcoholism | Yes | 68 | 4 | 133 | 7 | <0.001 |
No | 358 | 19 | 1313 | 70 | ||
COPD | Yes | 72 | 4 | 2 | >0.5 | <0.001 |
No | 354 | 23 | 1444 | 76.5 |
Reason for Stay at the ICU | VAP | |||||
---|---|---|---|---|---|---|
Yes | No | p | ||||
n | % | n | % | |||
Multiple organ injury | Yes | 81 | 4 | 52 | 3 | <0.001 |
No | 345 | 19 | 1394 | 74 | ||
Fractures, multiple fractures | Yes | 45 | 2 | 20 | 1 | <0.001 |
No | 381 | 21 | 1426 | 76 | ||
Hemorrhage, hemorrhagic shock | Yes | 10 | 1 | 137 | 7 | <0.001 |
No | 416 | 22 | 1309 | 70 |
Presence of Oropharyngeal Tubes | VAP Occurrence | Total | p | ||||
---|---|---|---|---|---|---|---|
Yes | No | ||||||
n | % | n | % | n | % | ||
Yes | 26 | 1 | 868 | 24 | 894 | 25 | 0.003 |
No | 360 | 9 | 2434 | 66 | 2794 | 75 | |
Total | 386 | 10 | 3302 | 90 | 3688 | 100 |
Type of Airway Breathing Assist Instrument | Occurrence of VAP | Total | p | ||||
---|---|---|---|---|---|---|---|
Yes | No | ||||||
n | % | n | % | n | % | ||
Intubation | 95 | 6 | 1315 | 88 | 1410 | 94 | 0.047 |
Tracheotomy | 1 | >0.5 | 83 | 6 | 84 | 6 | |
Total | 96 | 6 | 1398 | 94 | 1494 | 100 |
© 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
Share and Cite
Kózka, M.; Sega, A.; Wojnar-Gruszka, K.; Tarnawska, A.; Gniadek, A. Risk Factors of Pneumonia Associated with Mechanical Ventilation. Int. J. Environ. Res. Public Health 2020, 17, 656. https://doi.org/10.3390/ijerph17020656
Kózka M, Sega A, Wojnar-Gruszka K, Tarnawska A, Gniadek A. Risk Factors of Pneumonia Associated with Mechanical Ventilation. International Journal of Environmental Research and Public Health. 2020; 17(2):656. https://doi.org/10.3390/ijerph17020656
Chicago/Turabian StyleKózka, Maria, Aurelia Sega, Katarzyna Wojnar-Gruszka, Agnieszka Tarnawska, and Agnieszka Gniadek. 2020. "Risk Factors of Pneumonia Associated with Mechanical Ventilation" International Journal of Environmental Research and Public Health 17, no. 2: 656. https://doi.org/10.3390/ijerph17020656