Tap chi Y Hoc Thanh Pho Ho Chi Minh

Background: Ventilator-associated pneumonia (VAP) is the
second most common nosocomial infection in the intensive care unit (ICU) and
the most common in mechanically ventilated patients. Even when bundles of care
to prevent VAP have been implemented, the incidence of VAP was not dramatically
improved, and VAP is still a serious illness with substantial morbidity and
mortality and increases the cost of hospital care.

Objective: Identify the incidence of VAP and its risk factors,
causes, antibiotic resistance, mortality rate in two groups of early-onset and
late-onset VAP.

Method: A prospective study was conducted at the
Intensive Care Unit (ICU) and Neurosurgical Intensive Care Unit (Neuro-ICU) of
Cho Ray hospital from October 2013 to June 2014.

Results: The incidence of VAP was 35.8%. Early-onset and
late-onset VAP was observed in 36.8% and 63.2%,
with the mortality rate was 4.8% and 47.2%, respectively (p<0.0001). The
independent risk factors for VAP were APACHE II score > 20, renal failure,
prolonged mechanical ventilation. The three most prevalent gram negatives were:
Acinetobacter baumanii (61.7%), Klebsiella pneumonia (21.3%), Pseudomonas
aeruginosa (4.3%); the most common gram positive organism was Staphylococcus
aureus (27.7%).

Conclusion: VAP had high incidence and mortality.
Acinetobacter baumanii was the most common pathogen. With the antibiotic
resistance increased over years, Acinetobacter baumanii has become a pandemic
in ICUs.

Keywords: hospital-acquired pneumonia, ventilation
associated pneumonia, antibiotic resistance.