Incidence and outcomes of ventilator associated pneumonia in pediatric patients: an observational study

Ashok Kumar Ashok Kumar; Suresh N. Singh; Vijay K. Singh; Priyanka Singh; Bhoopendra Sharma; Harish C. Tiwari

doi:10.18203/2349-3291.ijcp20241359

Authors

Ashok Kumar Ashok Kumar Department of Pediatrics, B. R. D. Medical College, Gorakhpur, Uttar Pradesh, India
Suresh N. Singh Department of Pediatrics, B. R. D. Medical College, Gorakhpur, Uttar Pradesh, India
Vijay K. Singh Department of Pediatrics, B. R. D. Medical College, Gorakhpur, Uttar Pradesh, India
Priyanka Singh Department of Pediatrics, B. R. D. Medical College, Gorakhpur, Uttar Pradesh, India
Bhoopendra Sharma Department of Pediatrics, B. R. D. Medical College, Gorakhpur, Uttar Pradesh, India
Harish C. Tiwari Department of Community Medicine, B. R. D. Medical College, Gorakhpur, Uttar Pradesh, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20241359

Keywords:

Clinical pulmonary infection score, Ventilator associated pneumonia, Pediatric intensive care unit, ETA

Abstract

Background: Ventilator associated pneumonia (VAP) is very common in pediatric intensive care unit (PICU) intubated patients and also responsible for major morbidity and mortality. Usually, it develops after 48 hours of mechanically ventilated patients, its incidence increases as the duration of time increases and it is a major risk factor for VAP. The present study was carried out to know the overall incidence of VAP in mechanically ventilated patients in PICU.

Methods: The study was carried out in PICU of the department of pediatrics, B. R. D. Medical College, Gorakhpur from October 2020 to October 2021. Patients aged between 1 year to 15 years were included in the study.

Results: There were 50 (59.5%) patients’ male and 34 (40.5%) patients’ female under investigation. The clinical pulmonary infection score (CPIS) values ranged from the mean value of 4.38±2.30 at 36th hours to 7.33±1.92 at 96th hours of intubation. VAP was present in 23 (27.3%) patients while 62 (73.8%) patients were having no VAP. Among VAP associated patients, 14.3% were Acinetobacter positive, 5.95% were Klebsiella positive and 3.57% were E. coli positive.

Conclusions: Parameters of CPIS associated with VAP revealed that Acinetobactor was comparative more common organism and the age group of 1 to 5 years was more sensitive. VAP can be reduced by decreasing the duration of mechanical ventilation.

Metrics

Metrics Loading ...

References

Koenig SM, Truwit JD. Ventilator-associated pneumonia: diagnosis, treatment, and prevention. Clin Microbiol Rev. 2006;19(4):637-57.

Gauvin F, Dassa C, Chaïbou M, Proulx F, Farrell CA, Lacroix J. Ventilator-associated pneumonia in intubated children: comparison of different diagnostic methods. Pediatr Crit Care Med. 2003;4(4):437-43.

Raymond J, Aujard Y. Nosocomial Infections in Pediatric Patients: A European, Multicenter Prospective Study. Infect Control Hosp Epidemiol. 2000;21:260-3.

Patria MF, Chidini G, Ughi L, Montani C, Prandi E, Galeone C, et al. Ventilator-associated pneumonia in an Italian pediatric intensive care unit: a prospective study. World J Pediatr. 2013;9(4):365-8.

Aelami MH, Lotfi M, Zingg W. Ventilator-associated pneumonia in neonates, infants and children. Antimicrob Resist Infect Control. 2014;3:30.

Grohskopf LA, Sinkowitz-Cochran RL, Garrett DO, Sohn AH, Levine GL, Siegel JD, et al. A national point-prevalence survey of pediatric intensive care unit-acquired infections in the United States. J Pediatr. 2002;140(4):432-8.

Kepenekli E, Soysal A, Yalindag-Ozturk N, Ozgur O, Ozcan I, Devrim I, et al. Healthcare-Associated Infections in Pediatric Intensive Care Units in Turkey: a National Point-Prevalence Survey. Jpn J Infect Dis. 2015;68(5):381-6.

Dalmora CH, Deutschendorf C, Nagel F, dos Santos RP, Lisboa T. Defining ventilator-associated pneumonia: a (de)construction concept. Rev Bras Ter Intensiva. 2013;25(2):81-6.

Vijay G, Mandal A, Sankar J, Kapil A, Lodha R, Kabra SK. Ventilator Associated Pneumonia in Pediatric Intensive Care Unit: Incidence, Risk Factors and Etiological Agents. Indian J Pediatr. 2018;85(10):861-6.

Lachman P, Yuen S. Using care bundles to prevent infection in neonatal and pediatric ICUs. Curr Opin Infect Dis. 2009;22:224-8.

Solouki M, Mar'ashian SM, Koochak M, Nasiri A, Mokhtari M, Amirpour A. Ventilator-associated pneumonia among ICU patients receiving mechanical ventilation and prophylaxis of gastrointestinal bleeding. Arch Clin Infect Dis. 2009;4:177-80.

Srinivasan R, Asselin J, Gildengorin G, Wiener-Kronish J, Flori HR, et al. A prospective study of ventilator-assoclated pneumonia in children. Pediatrics. 2009;123:1108-15.

Amanati A, Karimi A, Fahimzad A, Shamshiri AR, Fallah F, Mahdavi A, et al. Incidence of Ventilator-Associated Pneumonia in Critically Ill Children Undergoing Mechanical Ventilation in Pediatric Intensive Care Unit. Children (Basel). 2017;4(7):56.

Vijay G, Mandal A, Sankar J, Kapil A, Lodha R, Kabra SK. Ventilator Associated Pneumonia in Pediatric Intensive Care Unit: Incidence, Risk Factors and Etiological Agents. Indian J Pediatr. 2018;85(10):861-6.

Rangelova VR, Raycheva RD, Kevorkyan AK, Krasteva MB, Kalchev YI. Ventilator-Associated Pneumonia in Neonates Admitted to a Tertiary Care NICU in Bulgaria. Front Pediatr. 2022;10:909217.