الفهرس | Only 14 pages are availabe for public view |
Abstract Medical devices are responsible for most of nosocomial infections in critically-ill patients. DAI can cause major medical and economic sequelae. The greatest threat against safety in the ICU is from DAI, particularly VAP. The VAP constitutes a serious problem in healthcare services as it is a common cause of morbidity and mortality among hospitalized patients. Currently, between 5% and 10% of patients admitted to acute care hospitals acquire at least one infection. The VAP may be attributed to by host, microbial and environmental factors. The VAP can lead to disabling conditions that reduce the quality of life, also the increased length of stay for infected patients and excess use of antibiotics are great contributors to increased economic burden. VAP is identified by using a combination of radiologic, clinical and laboratory criteria with patient intubated and ventilated at the time of or within 48 hours before the onset of the infection. This study was conducted as a prospective incidence-based surveillance on one hundred and seventy six adult patients , over a period of 12 months from Apri l 2011 to Aril 2012. Demographic, clinical data, APACHE II score for adults, and patients’ outcome were recorded for all patients. Cultures of ETA were performed for bacteriological identification of causative organisms of VAP and the diagnosis was made according to CDC/NHSN case definition. Total patients days and device days were recorded and VAP rate/1000 device days was calculated. Aerobic GNB were reported to cause more than 8 0% of VAP, especially Acinetobacter spps.(60.9%) and Pseudomonas spps(23%).were the most common isolated organisms. Summary 80 The VAP incidence rate in our study was 23.3% higher than NHSN rates. Increased LOS , ventilator days and old age showed significant differences. Lack of implementation of VAP prevention bundles and inadequate compliance to hand hygiene policy are possible contributing factors to the high VAP rates. Additionally patients with VAP had significantly higher crude extra mortality rates than non-infected. However, VAP is preventable, application of an adequate infection control program, following administrative measures in staff education, adequate nurse to patient ratio and preventing overcrowding, adherence to the standard precautions and implementation of ventilator prevention bundles, have major role in minimizing VAP. |