Prevalence of ventilator-associated pneumonia and associated factors among intubated adult patients admitted in public hospitals in Addis Ababa, Ethiopia: a facility-based retrospective study design.

BACKGROUND

Ventilator-associated pneumonia (VAP) occurs after 48 h of intubation or tracheostomy, leading to prolonged mechanical ventilation, increased healthcare costs, the emergence of antibiotic-resistant bacteria, and increased morbidity and mortality in resource-limited settings, including Ethiopia.

OBJECTIVES

This study aimed to determine the prevalence of ventilator-associated pneumonia and identify associated factors among intubated adult patients admitted to public hospitals in Addis Ababa, Ethiopia, in 2024.

METHODS

A facility-based retrospective study was conducted on 341 adult patients admitted to the intubated Intensive Care Unit (ICU) from 1 January 2021 to 30 December 2023. Variables with -values <0.05 in the bi-variable analysis were considered statistically significant.

RESULTS

A total of 335 patient charts were included in the study, with a response rate of 98.2%. More than half of the participants, 191 (57%), were male. The median age of patients was 40 years (IQR: 26-56 years). The study determined that the prevalence of ventilator-associated pneumonia (VAP) was 31.3% (95% CI: 26.3-36.4%). This study identified the following factors that increased the odds of ventilator-associated pneumonia: age of participants ≥60 years (AOR: 3.2, 95% CI: 1.51-7.12), re-intubation (AOR: 4.8, 95% CI: 2.4-9.4), duration of the patient on a mechanical ventilator (AOR: 3.2, 95% CI: 1.4-7.2), tracheostomy (AOR: 2.5, 95% CI: 1.2-5.2), and emergency intubation (AOR: 2.4, 95% CI: 1.3-4.6). These factors were significantly associated with VAP.

CONCLUSION

This study determined that nearly one-third of study participants developed VAP and identified factors that increased the odds of VAP, including: advanced age (AOR: 3.2, 95% CI: 1.51-7.12), re-intubation (AOR: 4.8, 95% CI: 2.4-9.4), duration of the patient on a mechanical ventilator (AOR: 3.2, 95% CI: 1.4-7.2), tracheostomy (AOR: 2.5, 95% CI: 1.2-5.2), and emergency intubation (AOR: 2.4, 95% CI: 1.3-4.6). Policymakers and health planners should address these factors to improve patient outcomes and healthcare costs among intubated adult patients admitted to public hospitals in Addis Ababa.