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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
Authors
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Authors Affiliations
  1. 1. Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
  2. 2. School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
  3. 3. Isfahan University of Medical Sciences, Isfahan, Iran

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.
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