Prevalence of Ventilator-associated Pneumonia Cases in Intensive Care Units of Two Tertiary-care Hospitals, Mekkah, Saudi Arabia, November 2013 - January 2014 Open Access

Abstract

OBJECTIVE: The primary objective is to determine the prevalence of ventilator-associated pneumonia (VAP) in two tertiary care hospitals in Mekkah, Kingdom of Saudia Arabia (KSA), between November 2013 and January 2014. The secondary objective is to describe the frequency of microorganisms causing VAP in these hospitals.

METHODS: We used secondary data from the intensive-care units (ICUs) of two tertiary-care hospitals in Mekkah. Three months of summarized data were collected on the total number of patients placed on ventilator and the number of patients developing VAP from November 2013 to January 2014. Data were collected on the number of infections in each ward and by floor. Data on different pathogens from each ward in the two hospitals were also collected and analyzed. We calculated the VAP rate using the number of infections/number of device days times 1000. We also calculated the utilization ratio using the number of device days/number of patient days. We estimated the VAP rate and 95% confidence interval (CI) for each hospital in each ICU over the study period. Rates were compared using rate ratios and 95% CIs. Significance was determined at the 5% level using two-sided P-values.

RESULTS: The VAP rates in Herra hospital were 18.87% for November, 10.24% for December, and 24% for January (per 1000 patient days). The VAP rates in Alnoor hospital were 12.20% for November, 8.21% for December, and 17.11% for January (per 1000 patient days). In Herra Hospital's MSICU ward, Acinetobacter contributed 67% of all pathogens, and in the NICU, it contributed 76% of all pathogens. In Alnoor Hospital's MED ward, Acinetobacter contributed to about 33% of all pathogens, in the ICU to 64%, and in the BURN ward, 67% of all pathogens. Additionally, Serritia and E. Coli also contributed largely to VAP infections in the CCU ward at Alnoor Hospital.

CONCLUSION: The overall VAP rate for both hospitals during the study period was higher than the expected NHSN rate, and there was no statistically significant difference in VAP rates between hospitals.

Table of Contents

Chapter 1 - Background and Introduction......................1

Chapter 2 - Literature Review.......................................4

Chapter 3 - Methods...................................................17

Chapter 4 - Results.....................................................19

Chapter 5 - Discussion................................................30

Chapter 6 - Conclusion and Recommendations.............33

References.................................................................36

About this Master's Thesis

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School	Rollins School of Public Health
Department	Hubert Department of Global Health
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, General Health Sciences, Medicine and Surgery Health Sciences, Epidemiology
Keyword	MAKKAH VENTILATOR ASSOCIATED PNEUMONIA
Committee Chair / Thesis Advisor	McNabb, Scott JN, Emory University
Partnering Agencies	Non-US governmental agency (e.g., Minister of Health in Haiti) International Non-governmental organization (e.g., CARE, Inc.) Hospital or other health care provider

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