الفهرس 
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Abstract
Medical devices are responsible for most of nosocomial infections in critically-ill
patients. DAI can cause major medical and economic sequelae. The greatest threat
against safety in the ICU is from DAI, particularly VAP.
The VAP constitutes a serious problem in healthcare services as it is a common cause
of morbidity
and mortality among hospitalized patients. Currently, between 5% and 10%
of patients admitted to acute care hospitals acquire at least one infection. The VAP may
be attributed to by host, microbial and environmental factors. The VAP can lead to
disabling conditions that reduce the quality of life, also the increased length of stay for
infected patients and excess use of antibiotics are great contributors to increased
economic burden.
VAP is identified by using a combination of radiologic, clinical and laboratory criteria
with patient
intubated and ventilated at the time of or within 48 hours before the onset of
the infection.
This study was conducted as a prospective incidence-based surveillance on one
hundred and seventy six adult patients
, over a period of 12 months from Apri
l 2011 to
Aril 2012.
Demographic, clinical data, APACHE II score for adults, and patients’ outcome were
recorded for all patients. Cultures of ETA were performed for bacteriological
identification of causative organisms of VAP and the diagnosis was made according to
CDC/NHSN case definition.
Total patients days and device days were recorded and VAP rate/1000 device days
was calculated.
Aerobic GNB were
reported to cause more than 8
0% of VAP, especially
Acinetobacter
spps.(60.9%) and
Pseudomonas spps(23%).were the most common
isolated organisms.
Summary
80
The VAP incidence rate in our study was 23.3% higher than NHSN rates.
Increased LOS , ventilator days and old age showed significant differences. Lack of
implementation of VAP prevention bundles and inadequate compliance to hand hygiene
policy are possible contributing factors to the high VAP rates. Additionally patients with
VAP had significantly higher crude extra mortality rates than non-infected.
However, VAP is preventable, application of an adequate infection control program,
following administrative measures in staff education, adequate nurse to patient ratio and
preventing overcrowding, adherence to the standard precautions and implementation of
ventilator prevention bundles, have major role in minimizing VAP.