Ventilator Associated Pneumonia Cases in the Postoperative Intensive Care Unit of a Cardiothoracic Surgery Center

Ventilator associated pneumonia (VAP) cases were investigated in a cardiothoracic surgery postoperative intensive care unit between 1 January 1999 and 1 January 2000. A total of 1716 patients who undergone cardiothoracic operations and followed in intensive care unit (ICU) were included in the study. Patient and laboratory based prospective surveillance study of VAP was done along with other hospital acquired infections. During the study period, a total of 26585 patient days with 2708 ventilator days were determined. 46 cases of VAP were founded in 36 of 1716 patients who undergone cardiothoracic operations (2.09%, 1.3 pneumonia/patient). Ventilator utilization rate at our institution was found to be 0.10. There were 16.4 VAP’s per 1000 ventilation days. 38% of VAP were caused by gram-negative enteric rods (27% Enterobacter spp., 8% Klebsiella spp., 3% Serratia spp.), 34% by Pseudomonas aeruginosa, 17% by Staphylococcus aureus. VAP was polymicrobial in 9% of cases. No causative microorganism was identified in 2% of cases. Same bacteria were isolated both in blood and endotracheal aspirate cultures in 10 of 46 pneumonia cases (22%). Crude mortality rate of VAP was calculated as 30%