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Ventilator-Associated Pneumonia in a Pediatric Intensive Care Unit in Saudi Arabia: A 30-Month Prospective Surveillance

Published online by Cambridge University Press:  02 January 2015

Maha Almuneef ,
Ziad A. Memish ,
Hanan H. Balkhy ,
Hala Alalem  and
Abdulrahman Abutaleb
Maha Almuneef
Affiliation:
Department of Infection Prevention and Control, King Abdulaziz Medical City, Riyadh, Saudi Arabia Department of Pediatrics, King Abdulaziz Medical City, Riyadh, Saudi Arabia
Ziad A. Memish*
Affiliation:
Department of Infection Prevention and Control, King Abdulaziz Medical City, Riyadh, Saudi Arabia Department of Internal Medicine, King Abdulaziz Medical City, Riyadh, Saudi Arabia
Hanan H. Balkhy
Affiliation:
Department of Infection Prevention and Control, King Abdulaziz Medical City, Riyadh, Saudi Arabia Department of Pediatrics, King Abdulaziz Medical City, Riyadh, Saudi Arabia
Hala Alalem
Affiliation:
Department of Pediatrics, King Abdulaziz Medical City, Riyadh, Saudi Arabia
Abdulrahman Abutaleb
Affiliation:
Department of Pediatrics, King Abdulaziz Medical City, Riyadh, Saudi Arabia
*
Infectious Diseases Division, Department of Medicine, and Executive Director, Infection Prevention & Control Program, King Abdulaziz Medical City, National Guard Health Affairs, P.O. Box 22490, Riyadh 11426, Saudi Arabia
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Abstract

Objective:

To describe the rate, risk factors, and outcome of ventilator-associated pneumonia (VAP) in pediatric patients.

Methods:

This prospective surveillance study of VAP among all patients receiving mechanical ventilation for 48 hours or more admitted to a pediatric intensive care unit (PICU) in Saudi Arabia from May 2000 to November 2002 used National Nosocomial Infections Surveillance (NNIS) System definitions.

Results:

Three hundred sixty-one eligible patients were enrolled. Most were Saudi with a mean age of 28.6 months. Thirty-seven developed VAP. The mean VAP rate was 8.87 per 1,000 ventilation-days with a ventilation utilization rate of 47%. The mean duration of mechanical ventilation was 21 days for VAP patients and 10 days for non-VAP patients. The mean PICU stay was 34 days for VAP patients and 15 days for non-VAP patients. Among VAP patients, Pseudomonas aeruginosa was the most common organism, followed by Staphylococcus aureus. Other gram-negative organisms were also encountered. There was no significant difference between VAP and non-VAP patients regarding mortality rate. Witnessed aspiration, reintubation, prior antibiotic therapy, continuous enteral feeding, and bronchoscopy were associated with VAP. On multiple logistic regression analysis, only prior antibiotic therapy, continuous enteral feeding, and bronchoscopy were independent predictors of VAP.

Conclusions:

The mean VAP rate in this hospital was higher than that reported by NNIS System surveillance of PICUs. This study has established a benchmark for future studies of VAP in the pediatric intensive care population in Saudi Arabia. Additional studies from the region are necessary for comparison and development of preventive measures.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 25 , Issue 9 , September 2004 , pp. 753 - 758
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2004

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