Risk Factors and Prognostic Predictors of VentilatorAssociated Pneumonia in a Tertiary Care Hospita

Oncul, Oral; ÇAGATAY, ARIF ATAHAN; basaran, seniha; Şimşek-Yavuz, Serap; orhun, günseli; Eraksoy, Haluk; OZSUT, HALIT; Çopur, Betül

doi:10.5578/flora.20229906

Risk Factors and Prognostic Predictors of VentilatorAssociated Pneumonia in a Tertiary Care Hospita

Betül ÇOPUR, (İstanbul Haseki Eğitim ve Araştırma Hastanesi, İnfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Kliniği, İstanbul, Türkiye)

Seniha BAŞARAN, (İstanbul Üniversitesi, Tıp Fakültesi, İnfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı, İstanbul, Türkiye)

Serap ŞİMŞEK YAVUZ, (İstanbul Üniversitesi, Tıp Fakültesi, İnfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı, İstanbul, Türkiye)

Atahan ÇAĞATAY, (İstanbul Üniversitesi, Tıp Fakültesi, İnfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı, İstanbul, Türkiye)

Oral ÖNCÜ, (İstanbul Üniversitesi, Tıp Fakültesi, İnfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı, İstanbul, Türkiye)

Halit ÖZSÜT, (İstanbul Üniversitesi, Tıp Fakültesi, İnfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı, İstanbul, Türkiye)

Haluk ERAKSOY, (İstanbul Üniversitesi, Tıp Fakültesi, İnfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı, İstanbul, Türkiye)

Günseli ORHUN (İstanbul Üniversitesi, Tıp Fakültesi, Anesteziyoloji ve Reanimasyon Anabilim Dalı, İstanbul, Türkiye)

Flora İnfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Dergisi

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Yıl: 2022 Cilt: 27 Sayı: 1 Sayfa Aralığı: 55 - 64 Metin Dili: İngilizce DOI: 10.5578/flora.20229906 İndeks Tarihi: 19-06-2022

Risk Factors and Prognostic Predictors of VentilatorAssociated Pneumonia in a Tertiary Care Hospita

Öz:

Introduction: It was aimed to evaluate the risk factors for the development of ventilator-associated pneumonia (VAP) and clinical outcomes and prognostic predictors of VAP. Materials and Methods: This retrospective and single-center study included patients aged ≥18 years who were diagnosed with VAP in the ICU. Patients were divided into two groups with VAP or without VAP. Univariable and multivariable analyses were used to assess risk factors and prognostic predictors of VAP. Results: A total of 177 patients were evaluated. Mean length of intensive care unit (ICU) stay and the duration of mechanical ventilation was longer in patients with VAP than in patients without VAP [29 (3-107) vs. 12 (3-70) days, 22 (3-90) vs. 10 (3-45) days; p< 0.001]. Rectal colonization with carbapenem-resistant Klebsiella pneumoniae (CRKp) was found to be higher in the VAP group compared to the non-VAP group (n= 41, 58% vs. n= 25, 24%, p< 0.001). Ventilation period (OR= 1.07; 95% CI 1.02-1.12, p= 0.003), smoking (OR= 3.89; 95% CI 1.68-8.9, p= 0.001), and rectal colonization with CRKp (OR= 4.93; 95% CI 2.09-11.64, p< 0.001) were detected as independent risk factors for the development of VAP. Age (OR= 1.15; 95% CI 1.03-1.28, p= 0.01), SOFA score (OR= 1.60; 95% CI 1.05-2.43, p= 0.02) and rectal colonization with CRKp (OR= 15.2; 95% CI 2.33-99.01, p= 0.004) were detected as independent risk factors for mortality in patients with VAP. Conclusion: In conclusion, decreasing the patient-related and hospital environment related risk factors, routine screening of rectal colonizations with CRKp, and continuous practicing of the universal infection control measures may significantly decrease the prevalence of ventilator-associated pneumonia.

Anahtar Kelime:

Üçüncü Basamak Bir Hastanede Ventilatörle İlişkili Pnömoninin PrognostikBelirteçleri ve Risk Faktörleri

Öz:

Giriş: Bu çalışmada ventilatörle ilişkili pnömoni (VİP) gelişimi için risk faktörlerini, VİP’ in klinik sonuçlarını ve prognostik belirleyicilerini araştırmayı amaçladık. Materyal ve Metod: Retrospektif ve tek merkezli yürütülen çalışmaya yoğun bakım ünitesinde (YBÜ) VİP tanısı almış 18 yaş ve üzeri hastalar dahil edildi. Hastalar VİP gelişen ve gelişmeyen olarak iki gruba ayrıldı. VİP’ in risk faktörlerini ve prognostik belirleyicilerini değerlendirmek için tek değişkenli ve çok değişkenli analizler kullanıldı. Bulgular: Toplam 177 hasta değerlendirildi. Ortalama YBÜ’de yatış ve mekanik ventilasyon süresi, VİP gelişen hastalarda gelişmeyen hastalara göre daha uzundu [29 (3-107) vs. 12 (3-70) gün, 22 (3-90) ve 10 (3-45) gün; p< 0.001]. Rektal karbapeneme dirençli Klebsiella pneumoniae (KDKp) kolonizasyonu VİP gelişmeyen gruba göre VİP grubunda daha yüksek bulundu (n= 41, %58 ve n= 25, %24, p< 0.001). Ventilasyon süresi (OR= 1.07; %95 CI 1.02-1.12, p= 0.003), sigara kullanımı (OR= 3.89; %95 CI 1.68-8.9, p= 0.001) ve rektal KDKp kolonizasyonu (OR= 4.93; %95 CI) 2.09-11.64, p< 0.001) VİP gelişimi için bağımsız risk faktörleri olarak saptandı. Yaş (OR= 1.15; %95 CI 1.03-1.28, p= 0.01), SOFA skoru (OR= 1.60; %95 CI 1.05-2.43, p= 0.02) ve rektal KDKp kolonizasyonu (OR= 15.2; %95 CI 2.33-99.01, p= 0.004) VİP grubunda mortalite için bağımsız risk faktörleri olarak saptandı. Sonuç: Hasta ve hastane ortamı ile ilişkili risk faktörlerinin azaltılması, rektal KDKp kolonizasyonun rutin olarak taranması ve evrensel enfeksiyon kontrol önlemlerinin sürekli uygulanması ventilatörle ilişkili pnömoni prevalansını önemli ölçüde azaltabilir.

Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

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APA	Çopur B, basaran s, Şimşek-Yavuz S, ÇAGATAY A, Oncul O, OZSUT H, Eraksoy H, orhun g (2022). Risk Factors and Prognostic Predictors of VentilatorAssociated Pneumonia in a Tertiary Care Hospita. , 55 - 64. 10.5578/flora.20229906
Chicago	Çopur Betül,basaran seniha,Şimşek-Yavuz Serap,ÇAGATAY ARIF ATAHAN,Oncul Oral,OZSUT HALIT,Eraksoy Haluk,orhun günseli Risk Factors and Prognostic Predictors of VentilatorAssociated Pneumonia in a Tertiary Care Hospita. (2022): 55 - 64. 10.5578/flora.20229906
MLA	Çopur Betül,basaran seniha,Şimşek-Yavuz Serap,ÇAGATAY ARIF ATAHAN,Oncul Oral,OZSUT HALIT,Eraksoy Haluk,orhun günseli Risk Factors and Prognostic Predictors of VentilatorAssociated Pneumonia in a Tertiary Care Hospita. , 2022, ss.55 - 64. 10.5578/flora.20229906
AMA	Çopur B,basaran s,Şimşek-Yavuz S,ÇAGATAY A,Oncul O,OZSUT H,Eraksoy H,orhun g Risk Factors and Prognostic Predictors of VentilatorAssociated Pneumonia in a Tertiary Care Hospita. . 2022; 55 - 64. 10.5578/flora.20229906
Vancouver	Çopur B,basaran s,Şimşek-Yavuz S,ÇAGATAY A,Oncul O,OZSUT H,Eraksoy H,orhun g Risk Factors and Prognostic Predictors of VentilatorAssociated Pneumonia in a Tertiary Care Hospita. . 2022; 55 - 64. 10.5578/flora.20229906
IEEE	Çopur B,basaran s,Şimşek-Yavuz S,ÇAGATAY A,Oncul O,OZSUT H,Eraksoy H,orhun g "Risk Factors and Prognostic Predictors of VentilatorAssociated Pneumonia in a Tertiary Care Hospita." , ss.55 - 64, 2022. 10.5578/flora.20229906
ISNAD	Çopur, Betül vd. "Risk Factors and Prognostic Predictors of VentilatorAssociated Pneumonia in a Tertiary Care Hospita". (2022), 55-64. https://doi.org/10.5578/flora.20229906

APA	Çopur B, basaran s, Şimşek-Yavuz S, ÇAGATAY A, Oncul O, OZSUT H, Eraksoy H, orhun g (2022). Risk Factors and Prognostic Predictors of VentilatorAssociated Pneumonia in a Tertiary Care Hospita. Flora İnfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Dergisi, 27(1), 55 - 64. 10.5578/flora.20229906
Chicago	Çopur Betül,basaran seniha,Şimşek-Yavuz Serap,ÇAGATAY ARIF ATAHAN,Oncul Oral,OZSUT HALIT,Eraksoy Haluk,orhun günseli Risk Factors and Prognostic Predictors of VentilatorAssociated Pneumonia in a Tertiary Care Hospita. Flora İnfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Dergisi 27, no.1 (2022): 55 - 64. 10.5578/flora.20229906
MLA	Çopur Betül,basaran seniha,Şimşek-Yavuz Serap,ÇAGATAY ARIF ATAHAN,Oncul Oral,OZSUT HALIT,Eraksoy Haluk,orhun günseli Risk Factors and Prognostic Predictors of VentilatorAssociated Pneumonia in a Tertiary Care Hospita. Flora İnfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Dergisi, vol.27, no.1, 2022, ss.55 - 64. 10.5578/flora.20229906
AMA	Çopur B,basaran s,Şimşek-Yavuz S,ÇAGATAY A,Oncul O,OZSUT H,Eraksoy H,orhun g Risk Factors and Prognostic Predictors of VentilatorAssociated Pneumonia in a Tertiary Care Hospita. Flora İnfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Dergisi. 2022; 27(1): 55 - 64. 10.5578/flora.20229906
Vancouver	Çopur B,basaran s,Şimşek-Yavuz S,ÇAGATAY A,Oncul O,OZSUT H,Eraksoy H,orhun g Risk Factors and Prognostic Predictors of VentilatorAssociated Pneumonia in a Tertiary Care Hospita. Flora İnfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Dergisi. 2022; 27(1): 55 - 64. 10.5578/flora.20229906
IEEE	Çopur B,basaran s,Şimşek-Yavuz S,ÇAGATAY A,Oncul O,OZSUT H,Eraksoy H,orhun g "Risk Factors and Prognostic Predictors of VentilatorAssociated Pneumonia in a Tertiary Care Hospita." Flora İnfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Dergisi, 27, ss.55 - 64, 2022. 10.5578/flora.20229906
ISNAD	Çopur, Betül vd. "Risk Factors and Prognostic Predictors of VentilatorAssociated Pneumonia in a Tertiary Care Hospita". Flora İnfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Dergisi 27/1 (2022), 55-64. https://doi.org/10.5578/flora.20229906