Publication:

Clinical profile of ventilator-associated pneumonia and its correlation between risk factor, morbidity and mortality in children

Background Mechanical ventilation (MV) is often necessary to manage critically ill pediatric patients admitted in the ICU. Nonetheless, it presents certain complications, including the potential risk of developing ventilator-associated pneumonia (VAP). The main objective of the present study was to evaluate the clinical profile and risk factor associated with the morbidity and mortality in children with VAP.

Methods This was a cross-sectional observational study conducted on 120 children aged 1 month 12 years who were mechanically ventilated. All enrolled children were evaluated daily for the onset of ventilator-associated pneumonia (VAP). Chest radiography and microbiological sampling was performed in children suspected with VAP. Duration of hospital stays, ventilator days and reintubation were also recorded.

Results Out of 120 children, 35 (29.2%) had developed VAP and the prevalence of VAP is estimated to be 29.2%. The most prevalent pathogen associated with VAP was K. pneumonia in 18 (51.4%) of the children. The duration of MV (28.65±12.76 vs 9.87±6.87, p<0.001 and hospital stay (35.87±8.15 vs 15.76±4.12; p=0.001) was higher in VAP as compared to no VAP and it was significant. Bivariate analysis revealed that use of steroids (p=0.004), sedative (p=0.01) and reintubation (p=0.003) was found to be significant risk factor for the development of VAP. The incidence of mortality in VAP was 4/35, i.e., 11.4%.

Conclusions About one-third of the children developed VAP. Klebsiella was the most predominate isolate and duration of MV and hospital stay were important predictors for VAP.