Ventilator associated pneumonia surveillance in critically ill patients with COVID-19 in a tertiary care hospital

Abstract

<b>Background:</b> Ventilator associated events (VAE) algorithm is increasingly used for the surveillance of ventilator associated problems as an alternative tool of traditional ventilator associated pneumonia (VAP) definition for surveillance. COVID-19’s impact on reliability of VAE for&nbsp;VAP is poorly defined. <b>Aims and objectives:</b> To compare the performance of traditional VAP criteria with VAE criteria to detect ventilator associated problems in intensive care unit (ICU) patients with COVID-19 pneumonia. <b>Methods:</b> Patients who were intubated for more than 48 hours in COVID-19 ICU were included. COVID-19 was diagnosed with polymerase chain reaction. For traditional VAP surveillance definition, CDC PNEU/VAP criteria were used. For VAE definition, CDC/NHSN VAE algorithm was used. Both VAE and PNEU/VAP surveillance were conducted manually by two investigators who were blind to each other. NHSN VAE calculator version 8.1 was used to verify VAE. <b>Results:</b> Seventy-seven patients met inclusion criteria during the 1-year study period. Mean (± SD) age was 68.7 (±13), 67.5% were male, median Charlson comorbidity index score was 4 (IQR 3). Thirty-three patients were diagnosed as PNEU/VAP. VAE were detected in fifteen patients. Eleven patients met both VAP and VAE criteria. The VAP rate was 13.55 per 1000 ventilator days, VAE rate was 6.16 per 1000 ventilator days. <b>Conclusions:</b> CDC PNEU/VAP criteria detected higher rate of ventilator associated problems when compared with VAE in patients with COVID-19.