Abstract

Objective: The aim of this study was to investigate risk factors for ventilator-associated pneumonia (VAP) which developed in patients admitted to medical intensive care units. 

Methods: Patients who were 16 years old and above, dependent on a mechanical ventilator for more than 48 hours and without pulmonary infection on first admission were included in the study. STATA 9.0® (College Station, TX, USA) was employed for statistical analyses and p<0.05 was regarded as the significant value. 

Results: This study included 142 patients and 64 (45.1%) developed VAP. The incidence of VAP was 23.3 cases per 1000 ventilator-days. Univariate analysis showed that duration of mechanical ventilation (p<0.001), length of intensive care unit (p<0.001) and hospital stay (p<0.001), the APACHE II score (p<0.001), blood transfusion (p<0.001), enteral feeding (p=0.025), urinary infection (p<0.001), wound infection (p=0.045), presence of at least one region of infection (p<0.001), chronic obstructive pulmonary disease (p=0.003), diabetes mellitus (p<0.001), prior antibiotics (p=0.003), tracheotomy (p=0.003) and presence of central catheter (p<0.001) were associated with the development of VAP. Logistic regression analysis showed a relationship between VAP and duration of mechanical ventilation (p=0.015), the APACHE II score (p=0.001), blood transfusion (p=0.015), chronic obstructive pulmonary disease (p=0.036), diabetes mellitus (p=0.019) and presence of central catheter (p<0.001).

Conclusions: Defined risk factors for VAP should be recognized and an effective infection control program for the prevention of VAP should be applied. Surveillance results should be evaluated regularly in each unit and necessary precautions should be taken.