Early- and Late-Onset Ventilator-Associated Pneumonia in Emergency- and Non-emergency-Admitted Patients in the Intensive Care Units of Alzahra Hospital (Isfahan, Iran): Comparison of Bacterial Subgroups

One of the most prevalent infections in intensive care units (ICUs) is ventilator-associated pneumonia that divided in two groups of early- and late-onset pneumonia. The aim of this study was determining the prevalence of early- and late-onset ventilator-associated pneumonia (VAP) in emergency- and non-emergency-admitted patients in the intensive care units. In a prospective study، 100 patients hospitalized in intensive care units of Alzahra Hospital (Isfahan، Iran) who suffered from ventilator-associated pneumonia were selected. Based on the time of pneumonia onset، the patients were divided in early- (lower than 4 days) and late-onset (4 and over days) groups. The subtype of bacteria and patients’ characteristics were compared between the two groups. The mean age of the patients was 33. 85 ± 13. 27 years. 58 patients were emergency- and 42 were non-emergency-admitted. 23 (23%) patients suffered from late- and 77 (77%) from early-onset pneumonia. Prevalence rate of early-onset pneumonia was 75. 9% and 78. 6% in emergency- and non-emergency-admitted patients (P = 0. 75). The mean pneumonia score was 7. 26 ± 2. 07 and 7. 17 ± 1. 66 in late- and early-onset pneumonia، respectively (P = 0. 83). The most prevalent bacterial cause was methicillin-resistant Staphylococcus aureus (MRSA) (30. 4%) and Acinetobacter (33. 8%) in late- and early-onset pneumonia، respectively (P = 0. 10). A considerable part of happened ventilator-associated pneumonia in intensive care units was late-onset which my lead to increase of hospitalization time and mortality risk in these patients. In addition، antibiotic-resistant bacteria were more in late-onset pneumonia. Hence، daily visit of patients about ventilator-associated pneumonia and early treatment in suspected cases is recommended.