We assessed incidence and
outcomes of patients with ventilator-associated respiratory infections (VARI)
due to tracheobronchitis (VAT) and pneumonia (VAP), including length of
intensive care unit (ICU) stay and ventilator days. We also examined pathogens,
rate of progression from VAT to VAP, and impact of antibiotic therapy for VAT.
Data analysis included 234 patients, 100 patients (43%) had at least moderate
(+++) bacterial growth in their semi-quantitative endotracheal aspirate
(SQ-ETA) cultures. VAT and VAP were each diagnosed in 34 (15%) patients.Staphylococcus aureuswas the most common pathogen isolated
and had the highest rate of progression from VAT to VAP. Seven (21%) of the 34
patients were diagnosed with VAT that later progressed to VAP in averaged 3
days. Patients diagnosed with VAT had significantly more ventilator days (9 vs
6,p< 0.001), ICU days (17 vs 11,p< 0.001) and hospital days (22 vs
17,p< 0.001). No significant difference
was observed in the clinical outcomes of the 25 VAT patients with timely,
appropriate antibiotics compared to the 9 VAT patients who did not receive
timely appropriate antibiotics. VAT was a risk factor for increased ventilator
days, longer length of ICU and hospital stay. The time window from VAT to VAP
allowed physicians to identify the pathogens and sensitivity profile needed to
treat VAT with
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