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Ventilator-Associated Pneumonia, Multidrug-Resistant Bacteremia and Infection Control Interventions in an Intensive Care Unit: Analysis of Six-Year Time-Series Data

Ventilator-associated pneumonia (VAP) occurs more than 48h after mechanical ventilation and is associated with a high mortality rate. The current hospital-based study aims to investigate the association between VAP rate, incidence of bacteremia from multidrug-resistant (MDR) pathogens, and infection...

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Autores principales: Papanikolopoulou, Amalia, Maltezou, Helena C., Stoupis, Athina, Pangalis, Anastasia, Kouroumpetsis, Christos, Chronopoulou, Genovefa, Kalofissoudis, Yannis, Kostares, Evangelos, Boufidou, Fotini, Karalexi, Maria, Koumaki, Vasiliki, Pantazis, Nikos, Tsakris, Athanasios, Kantzanou, Maria
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9405435/
https://www.ncbi.nlm.nih.gov/pubmed/36009998
http://dx.doi.org/10.3390/antibiotics11081128
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author Papanikolopoulou, Amalia
Maltezou, Helena C.
Stoupis, Athina
Pangalis, Anastasia
Kouroumpetsis, Christos
Chronopoulou, Genovefa
Kalofissoudis, Yannis
Kostares, Evangelos
Boufidou, Fotini
Karalexi, Maria
Koumaki, Vasiliki
Pantazis, Nikos
Tsakris, Athanasios
Kantzanou, Maria
author_facet Papanikolopoulou, Amalia
Maltezou, Helena C.
Stoupis, Athina
Pangalis, Anastasia
Kouroumpetsis, Christos
Chronopoulou, Genovefa
Kalofissoudis, Yannis
Kostares, Evangelos
Boufidou, Fotini
Karalexi, Maria
Koumaki, Vasiliki
Pantazis, Nikos
Tsakris, Athanasios
Kantzanou, Maria
author_sort Papanikolopoulou, Amalia
collection PubMed
description Ventilator-associated pneumonia (VAP) occurs more than 48h after mechanical ventilation and is associated with a high mortality rate. The current hospital-based study aims to investigate the association between VAP rate, incidence of bacteremia from multidrug-resistant (MDR) pathogens, and infection control interventions in a single case mix ICU from 2013 to 2018. Methods: The following monthly indices were analyzed: (1) VAP rate; (2) use of hand hygiene disinfectants; (3) isolation rate of patients with MDR bacteria; and (4) incidence of bacteremia/1000 patient-days (total cases, total carbapenem-resistant cases, and carbapenem-resistant Acinetobacter baumannii, Pseudomonas aeruginosa, and Klebsiella pneumoniae cases separately). Results: Time trends of infection control interventions showed increased rates in isolation of patients with MDR pathogens (p <0.001) and consumption of hand disinfectant solutions (p =0.001). The last four years of the study an annual decrease of VAP rate by 35.12% (95% CI: −53.52 to −9.41; p =0.01) was recorded, which significantly correlated not only with reduced trauma and cardiothoracic surgery patients (IRR:2.49; 95% CI: 2.09–2.96; p <0.001), but also with increased isolation rate of patients with MDR pathogens (IRR: 0.52; 95% CI: 0.27–0.99; p = 0.048), and hand disinfectants use (IRR: 0.40; 95% CI: 0.18–0.89; p =0.024). Conclusions: Infection control interventions significantly contributed to the decrease of VAP rate. Constant infection control stewardship has a stable time-effect and guides evidence-based decisions.
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spelling pubmed-94054352022-08-26 Ventilator-Associated Pneumonia, Multidrug-Resistant Bacteremia and Infection Control Interventions in an Intensive Care Unit: Analysis of Six-Year Time-Series Data Papanikolopoulou, Amalia Maltezou, Helena C. Stoupis, Athina Pangalis, Anastasia Kouroumpetsis, Christos Chronopoulou, Genovefa Kalofissoudis, Yannis Kostares, Evangelos Boufidou, Fotini Karalexi, Maria Koumaki, Vasiliki Pantazis, Nikos Tsakris, Athanasios Kantzanou, Maria Antibiotics (Basel) Article Ventilator-associated pneumonia (VAP) occurs more than 48h after mechanical ventilation and is associated with a high mortality rate. The current hospital-based study aims to investigate the association between VAP rate, incidence of bacteremia from multidrug-resistant (MDR) pathogens, and infection control interventions in a single case mix ICU from 2013 to 2018. Methods: The following monthly indices were analyzed: (1) VAP rate; (2) use of hand hygiene disinfectants; (3) isolation rate of patients with MDR bacteria; and (4) incidence of bacteremia/1000 patient-days (total cases, total carbapenem-resistant cases, and carbapenem-resistant Acinetobacter baumannii, Pseudomonas aeruginosa, and Klebsiella pneumoniae cases separately). Results: Time trends of infection control interventions showed increased rates in isolation of patients with MDR pathogens (p <0.001) and consumption of hand disinfectant solutions (p =0.001). The last four years of the study an annual decrease of VAP rate by 35.12% (95% CI: −53.52 to −9.41; p =0.01) was recorded, which significantly correlated not only with reduced trauma and cardiothoracic surgery patients (IRR:2.49; 95% CI: 2.09–2.96; p <0.001), but also with increased isolation rate of patients with MDR pathogens (IRR: 0.52; 95% CI: 0.27–0.99; p = 0.048), and hand disinfectants use (IRR: 0.40; 95% CI: 0.18–0.89; p =0.024). Conclusions: Infection control interventions significantly contributed to the decrease of VAP rate. Constant infection control stewardship has a stable time-effect and guides evidence-based decisions. MDPI 2022-08-19 /pmc/articles/PMC9405435/ /pubmed/36009998 http://dx.doi.org/10.3390/antibiotics11081128 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Papanikolopoulou, Amalia
Maltezou, Helena C.
Stoupis, Athina
Pangalis, Anastasia
Kouroumpetsis, Christos
Chronopoulou, Genovefa
Kalofissoudis, Yannis
Kostares, Evangelos
Boufidou, Fotini
Karalexi, Maria
Koumaki, Vasiliki
Pantazis, Nikos
Tsakris, Athanasios
Kantzanou, Maria
Ventilator-Associated Pneumonia, Multidrug-Resistant Bacteremia and Infection Control Interventions in an Intensive Care Unit: Analysis of Six-Year Time-Series Data
title Ventilator-Associated Pneumonia, Multidrug-Resistant Bacteremia and Infection Control Interventions in an Intensive Care Unit: Analysis of Six-Year Time-Series Data
title_full Ventilator-Associated Pneumonia, Multidrug-Resistant Bacteremia and Infection Control Interventions in an Intensive Care Unit: Analysis of Six-Year Time-Series Data
title_fullStr Ventilator-Associated Pneumonia, Multidrug-Resistant Bacteremia and Infection Control Interventions in an Intensive Care Unit: Analysis of Six-Year Time-Series Data
title_full_unstemmed Ventilator-Associated Pneumonia, Multidrug-Resistant Bacteremia and Infection Control Interventions in an Intensive Care Unit: Analysis of Six-Year Time-Series Data
title_short Ventilator-Associated Pneumonia, Multidrug-Resistant Bacteremia and Infection Control Interventions in an Intensive Care Unit: Analysis of Six-Year Time-Series Data
title_sort ventilator-associated pneumonia, multidrug-resistant bacteremia and infection control interventions in an intensive care unit: analysis of six-year time-series data
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9405435/
https://www.ncbi.nlm.nih.gov/pubmed/36009998
http://dx.doi.org/10.3390/antibiotics11081128
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