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Ventilator Associated Pneumonia (VAP): a retrospective review of all children diagnosed with a VAP during 2017 and 2018, in the PICU, Red Cross War Memorial Children's Hospital.
Background: Ventilator Associated Pneumonia (VAP) is a common hospital acquired infection in children leading to an increase in morbidity and mortality. A study conducted in our PICU in 2013, showed that VAP rates decreased dramatically after implementation of a VAP bundle and appointing a VAP coord...
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| Format: | Thesis |
| Language: | English |
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Department of Paediatrics and Child Health
2022
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| _version_ | 1867613142887956480 |
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| access_status_str | Open Access |
| author | van Wyk, Liana |
| author2 | Salie, Shamiel |
| author_browse | Salie, Shamiel van Wyk, Liana |
| author_facet | Salie, Shamiel van Wyk, Liana |
| author_sort | van Wyk, Liana |
| collection | Thesis |
| description | Background: Ventilator Associated Pneumonia (VAP) is a common hospital acquired infection in children leading to an increase in morbidity and mortality. A study conducted in our PICU in 2013, showed that VAP rates decreased dramatically after implementation of a VAP bundle and appointing a VAP coordinator, to 4/1000 ventilator days. As part of a “Plan, Do, Study, Act” cycle, it was necessary to evaluate the efficacy of these interventions. Objectives: To evaluate the VAP rate in the PICU over a two year period from 2017 - 2018, and secondly to describe the causative organisms and antibiotic sensitivity/resistance patterns during this period. Methods: This was a retrospective, descriptive study using the existing PICU VAP database to identify cases. Additional information was retrieved from the PICU admission database as well as clinical folders. Results: Over the 2 years, 31 VAP cases were identified. The VAP rate in 2017 was 4.0 /1000 ventilator days and 5.4 /1000 ventilator days in 2018. Compliance with the VAP bundle was 68% in 2017 and 70% in 2018. The median(IQR) duration of ventilation in 2017 was 9 (6-12) days and 15 (11-28) days in 2018. The median(IQR) length of PICU stay in 2017 was 11 (8 – 22) days and 25 (17-37) days in 2018. The most common cultured organism was an ESBL Klebsiella pneumoniae sensitive to Amikacin and carbapenems. Conclusion: Our VAP rate has not decreased further since 2013. The VAP rate was slightly higher in 2018, and it is imperative that we improve compliance with the VAP bundle, in order to reduce VAP rates. Klebsiella pneumoniae and Pseudomonas aeruginosa were the commonest organisms causing VAPs and empiric use of Piptazobactam and Amikacin is still appropriate. |
| format | Thesis |
| id | oai:open.uct.ac.za:11427/36203 |
| institution | University of Cape Town (South Africa) |
| language | eng |
| last_indexed | 2026-06-10T12:31:26.417Z |
| license_str | Not specified — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository |
| publishDate | 2022 |
| publishDateRange | 2022 |
| publishDateSort | 2022 |
| publisher | Department of Paediatrics and Child Health |
| publisherStr | Department of Paediatrics and Child Health |
| record_format | dspace |
| source_str | UCTD — University of Cape Town Open Access Repository |
| spelling | oai:open.uct.ac.za:11427/36203 Ventilator Associated Pneumonia (VAP): a retrospective review of all children diagnosed with a VAP during 2017 and 2018, in the PICU, Red Cross War Memorial Children's Hospital. van Wyk, Liana Salie, Shamiel Paediatrics and Child Health Background: Ventilator Associated Pneumonia (VAP) is a common hospital acquired infection in children leading to an increase in morbidity and mortality. A study conducted in our PICU in 2013, showed that VAP rates decreased dramatically after implementation of a VAP bundle and appointing a VAP coordinator, to 4/1000 ventilator days. As part of a “Plan, Do, Study, Act” cycle, it was necessary to evaluate the efficacy of these interventions. Objectives: To evaluate the VAP rate in the PICU over a two year period from 2017 - 2018, and secondly to describe the causative organisms and antibiotic sensitivity/resistance patterns during this period. Methods: This was a retrospective, descriptive study using the existing PICU VAP database to identify cases. Additional information was retrieved from the PICU admission database as well as clinical folders. Results: Over the 2 years, 31 VAP cases were identified. The VAP rate in 2017 was 4.0 /1000 ventilator days and 5.4 /1000 ventilator days in 2018. Compliance with the VAP bundle was 68% in 2017 and 70% in 2018. The median(IQR) duration of ventilation in 2017 was 9 (6-12) days and 15 (11-28) days in 2018. The median(IQR) length of PICU stay in 2017 was 11 (8 – 22) days and 25 (17-37) days in 2018. The most common cultured organism was an ESBL Klebsiella pneumoniae sensitive to Amikacin and carbapenems. Conclusion: Our VAP rate has not decreased further since 2013. The VAP rate was slightly higher in 2018, and it is imperative that we improve compliance with the VAP bundle, in order to reduce VAP rates. Klebsiella pneumoniae and Pseudomonas aeruginosa were the commonest organisms causing VAPs and empiric use of Piptazobactam and Amikacin is still appropriate. 2022-03-22T10:48:01Z 2022-03-22T10:48:01Z 2021 2022-03-22T07:30:06Z Master Thesis Masters MMed http://hdl.handle.net/11427/36203 eng application/pdf Department of Paediatrics and Child Health Faculty of Health Sciences |
| spellingShingle | Paediatrics and Child Health van Wyk, Liana Ventilator Associated Pneumonia (VAP): a retrospective review of all children diagnosed with a VAP during 2017 and 2018, in the PICU, Red Cross War Memorial Children's Hospital. |
| thesis_degree_str | Master's |
| title | Ventilator Associated Pneumonia (VAP): a retrospective review of all children diagnosed with a VAP during 2017 and 2018, in the PICU, Red Cross War Memorial Children's Hospital. |
| title_full | Ventilator Associated Pneumonia (VAP): a retrospective review of all children diagnosed with a VAP during 2017 and 2018, in the PICU, Red Cross War Memorial Children's Hospital. |
| title_fullStr | Ventilator Associated Pneumonia (VAP): a retrospective review of all children diagnosed with a VAP during 2017 and 2018, in the PICU, Red Cross War Memorial Children's Hospital. |
| title_full_unstemmed | Ventilator Associated Pneumonia (VAP): a retrospective review of all children diagnosed with a VAP during 2017 and 2018, in the PICU, Red Cross War Memorial Children's Hospital. |
| title_short | Ventilator Associated Pneumonia (VAP): a retrospective review of all children diagnosed with a VAP during 2017 and 2018, in the PICU, Red Cross War Memorial Children's Hospital. |
| title_sort | ventilator associated pneumonia vap a retrospective review of all children diagnosed with a vap during 2017 and 2018 in the picu red cross war memorial children s hospital |
| topic | Paediatrics and Child Health |
| url | http://hdl.handle.net/11427/36203 |
| work_keys_str_mv | AT vanwykliana ventilatorassociatedpneumoniavaparetrospectivereviewofallchildrendiagnosedwithavapduring2017and2018inthepicuredcrosswarmemorialchildrenshospital |