Objective
To investigate the concordance between novel and conventional surveillance paradigms
for ventilator-associated pneumonia (VAP).
Methods
This study was conducted at a regional teaching hospital in southern Taiwan with 5
acute intensive care units. To assess the validity of novel ventilator-associated
event (VAE) surveillance, we retrospectively applied the VAE algorithm to analyze
all VAP cases that were identified using conventional definitions between April 2010
and February 2014. Patient outcomes, including ventilator days, hospital stay lengths,
and in-hospital mortality were recorded.
Results
Among 165 episodes of conventional VAP, 55 (33.3%), 40 (24.2%), 20 (12.1%), and 2
(1.2%) episodes were classified as a ventilator-associated condition, an infection-related
ventilator-associated complication, possible VAP, and probable VAP, respectively,
according to the new VAE algorithm. Changes in positive end-expiratory pressure and
inspired oxygen fraction levels during the development of VAP were significant higher
among each VAE category than for conventional VAP (all P < .001). In-hospital mortality was significantly higher among patients with ventilator-associated
condition than for patients with conventional VAP (P = .0185).
Conclusions
In our study population, novel VAE surveillance only detected one-third of conventional
VAP cases. Thus, more studies are needed to further validate VAE surveillance compared
with conventional VAP by using strong microbiologic criteria, particularly bronchoalveolar
lavage with a protected specimen brush for diagnosing VAP.
Key Word
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Article info
Publication history
Published online: December 13, 2014
Footnotes
HCC and CMC contributed equally to this work.
Conflicts of interest: None to report.
Identification
Copyright
© 2015 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
