Analysis of ventilator associated pneumonia (VAP) studies in Egyptian University Hospitals

Background: Ventilator associated pneumonia (VAP) is a dynamic disease caused by a wide spectrum of pathogens and associated with morbidity and mortality. Purpose: The study concerned with an analysis of VAP studies done in Egyptian University Hospitals in the last 10 years to describe the magnitude of the problem of VAP as a complication of mechanical ventilation, and to explore its predictors and most common causative organisms. Methods: To identify relevant published studies we searched the medical literature for articles done in Egypt published during the past 10 years, using midline PubMed and Google scholar, where the full text articles were downloaded. We also searched the thesis discussed and passed (Registered) at the website of the Egyptian Universities libraries consortium visiting the website of the supreme council of Egyptian Universities. Results: Most of the 37 studies on which analysis were done were concerned with the risk factors, causative organisms, and incidence. The most common risk factors were leukopenia, thrombocytopenia, high CRP, metabolic acidosis, nasal endotracheal intubation, re-intubation, prior antibiotic use, and contaminated ICU environment with lack of infection control measures, use of antacids and H2 blocker, corticosteroids use, and coma. The most common causative organisms were Pseudomonas aerogenosa, Klebsiella, Escherichia coli, Staphylococcus aureus, Acinetobacter, Candida and Proteus. Conclusion: It is important to establish large-scale multi center national studies to explore incidence of VAP, all possible risk factors (whether preventable or non preventable), causative organisms, and mortality due to VAP and its economic aspect