Reducing ventilator-associated pneumonia in neonatal intensive care unit using 'VAP prevention Bundle': a cohort study
| Autor: | Wafaa F Elsaeed, Hanan S. Sherbiny, Safaa H. Saleh, Wesam A. Mokhtar, Seham F. Azab, Nahla A. Elsamad, Nagwa E. Akeel, Tarek Gheith, Eman A. Bendary, Maha A. A. Basset, Ahmed G. Siam, Mona M. Elshafiey, Mohamed A. Arafa, Sanaa M. Ismail, Ashgan A. Alghobashy |
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| Rok vydání: | 2015 |
| Předmět: |
Male
Pediatrics medicine.medical_specialty Neonatal intensive care unit medicine.medical_treatment Infant Newborn Diseases Cohort Studies Hospitals University Neonate Intensive Care Units Neonatal medicine Humans Ventilator-associated pneumonia Infection control Prospective Studies Child Prospective cohort study Developing Countries Mechanical ventilation Cross Infection Infection Control business.industry Infant Newborn Pneumonia Ventilator-Associated Length of Stay medicine.disease Respiration Artificial Confidence interval respiratory tract diseases Pneumonia Infectious Diseases Emergency medicine Female Infection business Research Article Cohort study |
| Zdroj: | BMC Infectious Diseases |
| ISSN: | 1471-2334 |
| DOI: | 10.1186/s12879-015-1062-1 |
| Popis: | Background Ventilator-associated pneumonia (VAP) is a serious health care- associated infection, resulting in high morbidity and mortality. It also prolongs hospital stay and drives up hospital costs. Measures employed in preventing ventilator- associated pneumonia in developing countries are rarely reported. In this study we tried to assess the efficacy of our designed “VAP prevention bundle” in reducing VAP rate in our neonatal intensive care unit (NICU). Method This prospective before-and-after study was conducted at university hospital NICU, all neonates who had mechanical ventilation for ≥ 48 h were eligible. VAP rates were evaluated before (phase-I) and after (phase-II) full implementation of comprehensive preventive measures specifically designed by our infection control team. Results Of 143 mechanically ventilated neonates, 73 patients developed VAP (51 %) throughout the study period (2500 mechanical ventilation days). The rate of VAP was significantly reduced from 67.8 % (42/62) corresponding to 36.4 VAP episodes/1000 mechanical ventilation days (MV days) in phase-I to 38.2 % (31/81) corresponding to 23 VAP/1000 MV days (RR 0.565, 95 % confidence interval 0.408-0.782, p = 0.0006) after VAP prevention bundle implementation (phase-II). Parallel significant reduction in MV days/case were documented in post-intervention period (21.50 ± 7.6 days in phase-I versus 10.36 ± 5.2 days in phase-II, p = 0.000). There were a trend toward reduction in NICU length of stay (23.9 ± 10.3 versus 22.8 ± 9.6 days, p = 0.56) and overall mortality (25 % versus 17.3 %, p = 0.215) between the two phases but didn’t reach statistical significance. The commonest micro-organisms isolated throughout the study were gram-negative bacteria (63/66, 95.5 %) particularly Klebsilla pneumonia (55/66, 83.4 %). Conclusion Implementation of multifaceted infection control bundle resulted in reduction of VAP rate, length of stay in our NICU. |
| Databáze: | OpenAIRE |
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