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



Alikiaie B¹ ; Moradi D¹ ; Mosaddegh M² ; Salimi N² ; Mosaddegh J³
Source: Journal of Isfahan Medical School Published:2015

Abstract

Background: One of the most prevalent infections in intensive care units (ICUs) is ventilatorassociated 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 nonemergency-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. © 2014, Isfahan University of Medical Sciences(IUMS). All rights reserved.