Division of Infectious Diseases, American University of Beirut Medical Center, Beirut, Lebanon; Infection Control and Prevention Program, American University of Beirut Medical Center, Beirut, Lebanon.
Division of Infectious Diseases, American University of Beirut Medical Center, Beirut, Lebanon.
J Infect Public Health. 2019 Jul-Aug;12(4):492-495. doi: 10.1016/j.jiph.2019.01.057. Epub 2019 Feb 6.
Ventilator-associated pneumonia (VAP) is associated with significant adverse outcomes in critically-ill patients admitted to the Intensive Care Unit (ICU). Systematic data from Lebanon on VAP are not available and large epidemiological studies from the region are scarce.
We conducted a retrospective study over a 10-year period at the American University of Beirut Medical Center (AUBMC), a tertiary referral center in Lebanon in order to describe the incidence, microbiology, and temporal trends of VAP in the medical/surgical ICU.
A total of 162 patients developed VAP over the study period and the overall incidence of VAP was 7.9 per 1000 ventilator-days. There was a statistically significant decrease over time in the incidence of VAP, from 13.1 in 2008 to 1.1 per 1000 ventilator-days in 2017. Multidrug-resistant (MDR) Acinetobacter spp. was the predominant pathogen, both in early- as well as late-onset VAP, followed by Pseudomonas aeruginosa.
Following significant efforts from the Infection Control and Prevention Program, a considerable reduction in the incidence of VAP was achieved at AUBMC. The predominance of MDR Acinetobacter spp. should be taken into consideration when deciding on empirical therapy in patients with VAP.
呼吸机相关性肺炎（VAP）与重症监护病房（ICU）中入住的危重症患者的不良预后显著相关。黎巴嫩尚无 VAP 的系统数据，且该地区也鲜有大型流行病学研究。
我们在黎巴嫩贝鲁特美国大学医学中心（AUBMC）进行了一项为期 10 年的回顾性研究，以描述内科/外科 ICU 中 VAP 的发生率、微生物学和时间趋势。
研究期间共有 162 名患者发生 VAP，VAP 的总发生率为每 1000 个机械通气日 7.9 例。VAP 的发病率随时间呈统计学显著下降，从 2008 年的 13.1 例降至 2017 年的每 1000 个机械通气日 1.1 例。耐多药（MDR）不动杆菌属在早发性和迟发性 VAP 中均为主要病原体，其次是铜绿假单胞菌。
在感染控制和预防计划的大力推动下，AUBMC 的 VAP 发病率显著降低。在决定 VAP 患者的经验性治疗时，应考虑 MDR 不动杆菌属的优势。
