Issue: August 2013
July 03, 2013
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Ventilator-associated pneumonia in small hospitals often caused by MRSA

Issue: August 2013
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Methicillin-resistant Staphyloccocus aureus was commonly linked to the ventilator-associated pneumonia rate in community hospitals, according to study findings.

Deverick J. Anderson, MD, MPH, of the Duke Infection Control Outreach Network at Duke University Medical Center in Durham, N.C., and colleagues reported on ventilator-associated pneumonia (VAP) incidence data that were collected from infection preventionists working in small community hospitals who employed the National Healthcare Safety Network protocol. The prospective study included 31 community hospitals from 2007 to 2011.

Deverick Anderson, MD 

Deverick J. Anderson

The researchers reported some trends in VAP incidence; specifically that VAP incidence was higher in small hospitals than medium or large hospitals, despite using ventilators less often. The median age of 247 patients with VAP was 64 years; 136 (55.1%) were female.

The most common causative agents of VAP included MRSA (n=70, 27.9%), Pseudomonas (n=40, 16.3%), and Klebsiella (n=34, 13.3%), according to the study findings.

Data on outcomes were available in 214 cases (86.6%), and 75 (35%) cases died during hospitalization,” the researchers wrote.

Anderson and colleagues highlighted some study limitations; specifically that there is a lack of uniform criteria for defining and reporting VAP. However, they wrote, despite these limitations, “Our study has several strengths, including standardized surveillance methods, prospective data collection, a large number of hospitals, and a unique hospital setting.”

Anderson noted that “the findings from our study provide new information about this devastating infection. The fact that the smallest hospitals had the highest rates of VAP may be related to lack of resources or inexperience with evidence-based ventilator care.”

Deverick J Anderson, MD, MPH, can be reached at deverick.anderson@duke.edu.

Disclosure: Anderson reports no relevant financial disclosures.