Ventilator-associated Pneumonia In ICU Research Articles

Intervention Effect of Cluster Nursing on Ventilator Associated Pneumonia in ICU and Its Effect on Patient Satisfaction

Intervention Effect of Cluster Nursing on Ventilator Associated Pneumonia in ICU and Its Effect on Patient Satisfaction

Risk Factor Analysis of Pan-drug Resistant Acinetobacter baumannii-induced Ventilator-associated Pneumonia in ICU

This study was to investigate the risk factors of ventilator-associated pneumonia caused by pan-drug resistant Acinetobacter baumannii in emergency intensive care unit so as to provide related basis for clinical prevention. A total of 105 intensive care unit patients, who were treated with ventilator over 48 h in the First Affiliated Hospital of Anhui Medical University and developed Acinetobacter baumannii-induced ventilator-associated pneumonia from January 2017 to December 2018 were enrolled in this study, including 70 cases with pan-drug resistant Acinetobacter baumannii infection served as the pan-drug resistant group and 35 cases with non-pan-drug resistant Acinetobacter baumannii infection served as the control group. The univariate analysis and Logistic regression method were used to explore the risk factors of ventilator-associated pneumonia caused by pan-drug resistant Acinetobacter baumannii. The result of univariate analysis showed that the risk factors of pan-drug resistant Acinetobacter baumannii-induced ventilator-associated pneumonia included tracheotomy, enteral nutrition, the use of carbapenems and use of more than 3 antibiotics before infection. Logistic regression analysis showed that enteral nutrition and the use of carbapenems were independent risk factors of pan-drug resistant Acinetobacter baumannii-induced ventilator-associated pneumonia. In conclusion, enteral malnutrition and the use of carbapenems were the two significant risk factors for pan-drug resistant Acinetobacter baumannii-induced ventilator-associated pneumonia, which are necessary to take active preventive measures in clinical practice.

To Determine the Bacteriological Profile and Antibiotic Sensitivity Pattern of the Isolates Causing Ventilator Associated Pneumonia in ICU Patients

Background: Ventilator associated pneumonia (VAP) is a type of nosocomial pneumonia occurring in patients who are mechanically ventilated for more than 48 hours. VAP is the most common nosocomial infection occurring in the intensive care units and its incidence varies from 8% to 28%. AIMS & OBJECTIVES- This study was done to determine the bacteriological profile and antibiotic sensitivity pattern of the isolates obtained from the endotracheal aspirates of the clinically suspected patients of VAP in ICU. Materials & Methods: Ventilator associated pneumonia (VAP) is a type of nosocomial pneumonia occurring in patients who are mechanically ventilated for more than 48 hours. VAP is the most common nosocomial infection occurring in the intensive care units and its incidence varies from 8% to 28%. AIMS & OBJECTIVES- This study was done to determine the bacteriological profile and antibiotic sensitivity pattern of the isolates obtained from the endotracheal aspirates of the clinically suspected patients of VAP in ICU. Results: Out of 110 patients included in the study, only 85 patients were diagnosed as VAP patients based on clinical and microbiological criteria. Pseudomonas aeruginosa (35.55%) was the most common gram-negative isolate obtained in VAP cases followed by Escherichia coli (27.77%) and Acinetobacter baumanni (16.66%). Among Gram positive bacteria, Staphylococcus aureus 40 (80%) was the most common isolate. The most active antibiotic against the gram-negative isolates was imipenem (82.2%), followed by piperacillin-tazobactum (77.7%) and amikacin (63.3%). All the Gram-positive isolates were susceptible to vancomycin and linezolid. Conclusion: Due to the increasing incidence of multi drug resistant pathogens in ICU, early and correct diagnosis of VAP is an important challenge for critical care physicians. Hence, knowing the bacteriological profile causing VAP and their routine antibiotic susceptibility pattern can improve the patient’s clinical outcome.

Incidence and Outcome of Ventilator Associated Pneumonia in ICU of a Tertiary Care Hospital in Nepal

Ventilator associated pneumonia is an important intensive care unit acquired infection in mechanically ventilated patients. Early and correct diagnosis of Ventilator associated pneumonia is difficult but is an urgent challenge for an optimal antibiotic treatment. A prospective observational study was conducted in Intensive Care Unit of a tertiary care hospital in Nepal. Consecutive patients were considered during the study period, who met the criteria were included for the study. Clinical Pulmonary Infection Score was used to diagnose Ventilator associated pneumonia. Among 60 patients ventilated for more than 48 hours, 25 (41.6%) developed ventilator associated pneumonia. The incidence was 25 VAPs per 100 ventilated patients or 26 VAPs per 1000 ventilator days during the period of study. Days on ventilator and duration in ICU were higher in the VAP group. There was a trend towards increasing mortality in the VAP group (P value=0.06). There exists a high rate of VAP in our Intensive Care Unit. Targeted strategies aimed at reducing Ventilator associated pneumonia should be implemented to improve patient outcome and reduce length of Intensive Care Unit stay and costs.

Nursing research progress of ventilator associated pneumonia in ICU

ICU is the important place of ventilator associated pneumonia, the occurrence of fatality rate in patients with ventilator associated pneumonia is higher. In this paper, the cause of the ventilator associated pneumonia in ICU and nursing research progress are summarized, that enhance their awareness of the importance of nursing care and the use of normative evidence- based nursing in clinical practice thinking and nursing process, explore the nursing methods of more appropriate, to reduce the incidence of ventilator associated pneumonia in ICU is of great help. Key words: Nursing care; Pneumonia, ventilator-associated; Intensive care units; Progress

Bacterial contamination of the hands of intensive care unit staff during respiratory tract care: preliminary results

Optimal care of the respiratory tract (RT) is critical to prevent ventilator-associated pneumonia in ICU. The dynamics of microbial cross-transmission by the hands of health care workers (HCW) during RT care is currently unknown.

The implement of bundle care improves the incidence of ventilator-associated pneumonia in ICU

The implement of bundle care improves the incidence of ventilator-associated pneumonia in ICU

Comparison of the Effectiveness of Oral Care with Chlorhexidine and Povidone iodine on the Incidence of Ventilator Associated Pneumonia in ICU – A prospective randomized controlled study

Background: Mechanical ventilation is often required in 10-20% critically ill patients, may be because of respiratory or any other indication. There is always a risk of developing pneumonia in such patients. Any pneumonia developing after 48 hours of commencing mechanical ventilation in a patient with previously non infected lungs is labeled as ventilator associated pneumonia (VAP).It occurs in 9–27% of patients on mechanical ventillation. This study was aimed at comparing the effectiveness of oral care with povidone iodine and chlorhexidine in preventing VAP. Materials and methods: This prospective randomized study included 70 patients in critical care unit requiring mechanical ventilation for more than 72 hrs After obtaining permission from hospital ethical committee and written informed consent from the patients, they were randomly allocated in two groups of 35 each: group I and group II to receive oral care with povidone iodine and chlorhexidine respectively. Development of VAP was recorded on basis of clinical findings, x-ray and tracheal culture. Results &Conclusions: In group receiving oral care with povidone iodine, 6(11.4%) patients developed VAP as compared to chlorhexidine group only 4 (17.1%) patients developed VAP but it did not reach statistical significance. Thus oral care with chlorhexidine is superior in prevention of VAP as compared with povidone iodine mouth wash but more studies need to be done, with larger sample size.

Application of bundle intervention therapy in preventing ventilator associated pneumonia in ICU

Objective To examine the effect of bundle intervention therapy to prevent mechanically ventilated patients from ventilator associated pneumonia （VAP） after thoracic surgery. Methods 81 mechanically ventilated patients after thoracic surgery from January 2007 to December 2008 were selected as the control group, while 109 patients from January 2009 to November 2011 were selected as the intervention group. The control group received conventional nursing, while the intervention group received bundle intervention in addition, which included semi lying position （30-45 degrees）, closed suctioning, continuous aspiration of subglottic secretion, strict execution of hand hygiene, daily waking-up, assessment after extubation, early enteral nutrition, prevention of deep vein thrombsis and peptic ulcer, etc. The incidence rate of VAP was analyzed and compared between two groups. Results The incidence rate of VAP in the intervention group was 8.26%, obviously lower than that in the control group which was 20.99%. The difference was statistically significant （χ2 = 6. 376, P 〈 0. 05 ）. Conclusions Bundle intervention therapy can effectively reduce the incidence rate of VAP in mechanically ventilated patients from VAP after thoracic surgery, and is worthy of clinical application. Key words: Bundle intervention therapy; Ventilator associated pneumonia; Mechanically ventilation; ICU

The effect of target monitoring for ventilator-associated pneumonia in ICU

Objective To observe the clinical effect of target monitoring of ventilator-associated pneumonia ( VAP ) in ICU.Methods Target monitoring was performed on the ICU patients receiving ventilation from January 2011; and 340 of the patients were randomly selected to the study group.340 patients undergoing ventilatin in 2010 who received routine nursing intervention were enrolled to the control group.The incidence rate of ventilator-associated pneumonia was compared between the two groups.Results There was a significant difference in the incidence rate of ventilatorassociated pneumonia between the study group and the control group( 8.69‰ vs.27.03‰,P＜ 0.05 ).The pathogens for VAP were mainly Gram-positive bacteria.Conclusions Use of target monitoring for ventilator-associated pneumonia in ICU has a better preventive effect and is worth of applying in ICU. Key words: Target monitoring; Ventilator-associated pneumonia in ICU; Ventilator; Intensive care unit

Application of VAP bundles resulting in low incidence of VAP in ICU

Ventilator-associated pneumonia (VAP) is an airways infection that must have developed more than 48 hours after the patient was intubated. Reducing mortality due to ventilator-associated pneumonia requires an organized process that guarantees early recognition of pneumonia and consistent application of the best evidence-based practices. The Ventilator Bundle is a series of interventions developed by IHI related to ventilator care that, when implemented together, will achieve significantly better outcomes than when implemented individually.

Pathogenesis and drug resistance analysis in 57 ICU patient with ventilator associated pneumonia

Objective To analyse the pathogenesis of ventilator associated pneumonia (VAP) and their resistance to antibiotics and to guide treatment with antibiotics. Methods A retrospective clinical study in 57 ICU patients with VAP was carried out from 2007.1 to 2007.10. The pathogens and their drug resistance were analyzed. Results A total of 145 pathogen strains were isolated and identified by bacterial culture. The pathogenic bacteria in VAP was the Gram-negative bacilli (GNB, 51.72%), Gram-positive bacteria (GPB, 26.21%), fungi (22.07%). The major bacteria was pseudomonas semginosa, staplyloeoccus sureus, candida albicans and klebsiella pneumoniae. Drug sensitivity tests indicated that the GNB had lower drug resistance to imipenem, levofloxacin, meropenam, amikacin; the GPB had lower drug resistance to teicoplanin, vancomycin, linezolid, fusidate, fosfomycin: the fungi had lower drug resistance, to itraconazole, amphotericin, fluconazole. Conclusions The major pathogens in VAP were GNB and fungi infection were increased in recent years. Epidemiology and drug sensitivity tests of pathogens must be consided when we treat VAP in ICU. Key words: ICU; Respiratory-associated pneumonia; Etiology; Susceptibility

院内感染予防と口腔ケアの重要性

The current foundation of preventing nosocomial infection in dental settings are “Guidelines for infection control in dental health-care settings” announced in 2003 by Centers for Disease Control and Prevention (CDC). These guidelines employ a concept of standard precaution in clinical dentistry, and had a great influence on “Guideline for infection control in dental prosthetics” established in 2007 by Japan Prosthodontic Society and “Guideline for infection control in dentistry” announced by the dental division of the infection control conference of the national university hospitals in 2008. On the other hand, there have been many reports about oral care, for instance, ‘1) oral care prevents aspiration-related pneumonia', ‘2) oral care decreases the onset rate of the influenza to a one-tenth, (oral care decreases significantly neuraminidase and protease which bacteria produce) ', ‘3) oral care reduces a side effect in the oral cavity by the chemoradiotherapy', ‘4) oral care prevents ventilator-associated pneumonia in ICU', ‘5) oral care is useful for symptom relief in terminal illness', and an importance of oral care has been widely noticed in late years.

Analysis of ventilator associated pneumonia in ICU

Objective To investigate the neurosurgery intensive care unit venti-lator-associated pneumonia (VAP) of morbidity, mortality, risk factors, as well as diagno-sis and treatment for the prevention and treatment of VAP and to provide a scientific basis.Methods A retrospective analysis of hospital surgical ICU patients with mechanical venti-lation neurosurgery under the VAP occurred in the clinical characteristics of a variety of clinical information and sputum culture, summed up the experience of diagnosis and treatment,and the corresponding control measures. Results In the ICU ward of neurosurgery YAP incidence of 37.76 percent, the death of 20 patients (54.05%), related risk factors: age>60 years old, was in a coma and a variety of invasive operation, tracheotomy, chronic obstructive pulmonary disease, mechanical ventilation > 3d (P all <0.05). The main pathogens as Pseudomonas aeruginosa, Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae and fungi. Conclusions The neurosurgery intensive care unit patients with high incidence of YAP, a long-term mechanical ventilation in patients with ventilator-time increase in the incidence of VAP, and the adverse impact on the prognosis should be off-line as soon as possible. Key words: Echanical ventilation; Ventilator-associated pneumonia; Risk factors