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Open Access Research article

Epidemiology and outcomes of ventilator-associated pneumonia in northern Brazil: an analytical descriptive prospective cohort study

Marília M Resende12, Sílvio G Monteiro23, Bianca Callegari4, Patrícia M S Figueiredo2, Cinara R A V Monteiro2 and Valério Monteiro-Neto256*

Author affiliations

1 Faculdade Estácio Seama, Macapá, Amapá, Brazil

2 Laboratório de Microbiologia, Universidade CEUMA, São Luís, Maranhão, Brazil

3 Departamento de Ciências Biológicas, Universidade Federal do Maranhão, São Luís, Maranhão, Brazil

4 Instituto de Ciências da Saúde, Universidade Federal do Pará, Belém, Pará, Brazil

5 Departamento de Patologia, Universidade Federal do Maranhão, São Luís, Maranhão, Brazil

6 Pró-Reitoria de Pós-Graduação, Pesquisa e Extensão, Universidade CEUMA, Rua Josué Montello No.1, CEP: 65.075-120, São Luís, MA, Brazil

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Citation and License

BMC Infectious Diseases 2013, 13:119  doi:10.1186/1471-2334-13-119

Published: 5 March 2013

Abstract

Background

Ventilator-associated pneumonia (VAP) is considered the most common nosocomial infection in the intensive care unit (ICU), but its features are not fully known in many hospitals in Brazil. We identified clinical and epidemiological aspects associated with VAP in an intensive care unit (ICU) in a general public hospital in northern Brazil and performed an analytical descriptive prospective cohort study.

Methods

We analyzed data from thirty-three patients who developed VAP while in the ICU. Clinical and epidemiological data of patients were obtained and tracheal secretions were submitted to culture. Microbial isolates were identified and evaluated for resistance against antimicrobial agents by using the automated Vitek 2 system.

Results

The frequency of VAP was 26.2% in patients submitted to invasive mechanical ventilation for at least 48 hours, and death occurred in 78.8% of cases. Only the presence of comorbidity showed a significant association (P = 0.029) with death. The most commonly found bacteria were Pseudomonas aeruginosa, Acinetobacter spp., and Enterobacteriaceae. We also found a frequency of 54.5% of multiresistant bacteria associated with VAP, and previous antibiotic therapy was used in 97% of patients.

Conclusions

VAP in our ICU presented with a high frequency and was mainly caused by multiresistant bacteria. Implementation of rational protocols for the use of antibacterial agents and rapid delivery of culture and susceptibility test results are essential. This may help decrease VAP-related mortality rates by multiresistant bacteria in the ICU.

Keywords:
Ventilator-associated pneumonia; Invasive mechanical ventilation; Bacterial multiresistance; Epidemiology