Risk factors for acquisition of ventilator-associated pneumonia in adult intensive care units

Objective: ventilator associated pneumonia (vap) has an imperative place amongst nosocomial infections leading to increase morbidity and mortality rates. the present study aimed to determine risk factors for acquisition of ventilator- associated pneumonia in an intensive care unit (icu). methods: a nested case-control study was carried out from september 2007 to june 2008. all 183 patients hospitalized at the adult icu ward in be’sat hospital, sanandaj city western iran over a 48 hour period were included. bacteriologic diagnosis and antibiotic susceptibility patterns were performed based on edward & ewing’s methods and clsi system guidelines. results: of the 149 samples which were taken from endotracheal tubes of 183 patients, 48 cases were diagnosed for vap with an incidence rate of 26.2%. mean duration of hospitalization was 23.4±10.2 days. the maximum and minimum antibiotic resistance for the gram negative bacteria was 93.3% for cefalotin and 50% for amikacin. the main risk factors for acquisition of ventilator- associated pneumonia were mechanical ventilation (adjusted or: 1.55, 95% ci: 1.37-1.74), history of antibiotic consumption (aor: 8.92, ci: 1.16- 66.66) and fever (aor: 3.11, ci: 1.22- 7.93). conclusions: vap is significantly related to icu hospitalization, mechanical ventilation and history of antibiotics consumption. cefalotin and amikacin showed the highest and lowest antibiotic resistance against gram negative bacteria respectively.