Journal of Isfahan Medical School

Journal of Isfahan Medical School

Early- and Late-Onset Ventilator-Associated Pneumonia in Emergency- and Non-emergency-Admitted Patients in the Intensive Care Units of Alzahra Hospital (Isfahan, Iran): Comparison of Bacterial Subgroups

Document Type : Original Article (s)

Authors
Babak Alikiaie 1
Daryoush Moradi 1
Maryam Mosaddegh 2
Nima Salimi 2
Jamshid Mosaddegh 3
1 Assistant Professor, Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
2 Student of Medicine, School of Medicine AND Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran
3 General Practitioner, Isfahan University of Medical Sciences, Isfahan, Iran
Abstract
Background: One of the most prevalent infections in intensive care units (ICUs) is ventilator-associated pneumonia that divided in two groups of early- and late-onset pneumonia. The aim of this study was determining the prevalence of early- and late-onset ventilator-associated pneumonia (VAP) in emergency- and non-emergency-admitted patients in the intensive care units.Methods: In a prospective study, 100 patients hospitalized in intensive care units of Alzahra Hospital (Isfahan, Iran) who suffered from ventilator-associated pneumonia were selected. Based on the time of pneumonia onset, the patients were divided in early- (lower than 4 days) and late-onset (4 and over days) groups. The subtype of bacteria and patients’ characteristics were compared between the two groups.Findings: The mean age of the patients was 33.85 ± 13.27 years. 58 patients were emergency- and 42 were non-emergency-admitted. 23 (23%) patients suffered from late- and 77 (77%) from early-onset pneumonia. Prevalence rate of early-onset pneumonia was 75.9% and 78.6% in emergency- and non-emergency-admitted patients (P = 0.75). The mean pneumonia score was 7.26 ± 2.07 and 7.17 ± 1.66 in late- and early-onset pneumonia, respectively (P = 0.83). The most prevalent bacterial cause was methicillin-resistant Staphylococcus aureus (MRSA) (30.4%) and Acinetobacter (33.8%) in late- and early-onset pneumonia, respectively (P = 0.10).Conclusion: A considerable part of happened ventilator-associated pneumonia in intensive care units was late-onset which my lead to increase of hospitalization time and mortality risk in these patients. In addition, antibiotic-resistant bacteria were more in late-onset pneumonia. Hence, daily visit of patients about ventilator-associated pneumonia and early treatment in suspected cases is recommended.
Keywords
Ventilator-associated pneumonia
Early-onset
Late-onset
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Journal of Isfahan Medical School
Volume 33, Issue 344 - Serial Number 344
May and June 2015
Pages 1220-1232

  • Receive Date 26 July 2015
  • Accept Date 06 April 2022