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Article ; Online: Ventilator-associated pneumonia in PICU - how are we doing?

van Wyk, L / Applegate, J T / Salie, S

The Southern African journal of critical care : the official journal of the Critical Care Society

2022  Volume 38, Issue 2

Abstract: Background: Ventilator-associated pneumonia (VAP) is a common hospital-acquired infection in children, leading to an increase in morbidity and mortality. A previous study in 2013 showed that VAP rates decreased dramatically after implementation of a VAP ...

Abstract Background: Ventilator-associated pneumonia (VAP) is a common hospital-acquired infection in children, leading to an increase in morbidity and mortality. A previous study in 2013 showed that VAP rates decreased dramatically after implementation of a VAP bundle and appointing a VAP coordinator. As part of a 'Plan, Do, Study, Act' cycle, it was necessary to evaluate the efficacy of these interventions.
Objectives: To evaluate the VAP rate in the paediatric intensive care unit (PICU) over 2 years (2017 - 2018), and to describe the causative organisms and antibiotic sensitivity/resistance patterns during this period.
Methods: This was a retrospective, descriptive study using the existing PICU VAP database as well as clinical folders.
Results: Over the 2 years, 31 VAP cases were identified. The VAP rate for 2017 was 4.0/1 000 ventilator days and 5.4/1 000 ventilator days for 2018. Compliance with the VAP bundle was 68% in 2017 and 70% in 2018. The median (interquartile range (IQR)) duration of ventilation in 2017 was 9 (6 -12) days and 15 (11 - 28) days in 2018. The median (IQR) length of PICU stay in 2017 was 11 (8 - 22) days and 25 (17 - 37) days in 2018. The most common cultured organism was an extended-spectrum beta-lactamase (ESBL)
Conclusion: Our VAP rate has not decreased since 2013. It is imperative that we improve compliance with the VAP bundle, in order to reduce VAP rates.
Contributions of the study: This study highlights the need for ongoing evaluation of quality improvement initiatives in PICU, considering that VAP rates remained largely unchanged from 2013 to 2018.
Language English
Publishing date 2022-08-05
Publishing country South Africa
Document type Journal Article
ZDB-ID 1218506-1
ISSN 2078-676X ; 1562-8264
ISSN (online) 2078-676X
ISSN 1562-8264
DOI 10.7196/SAJCC.2022.v38i2.536
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