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Updated: Jul 5, 2026
04:32
Murine Oropharyngeal Aspiration Model of Ventilator-associated and Hospital-acquired Bacterial Pneumonia
Published on: June 28, 2018
Ventilator-associated pneumonia in adults in developing countries: a systematic review
Yaseen Arabi1, Nehad Al-Shirawi, Ziad Memish
1Intensive Care Department, King Abdulaziz Medical City, ICU 1425, PO Box 22490, Riyadh 11426, Saudi Arabia. arabi@ngha.med.sa
Summary
Ventilator-associated pneumonia (VAP) rates are higher in developing countries and linked to worse patient outcomes. Further research is needed on practical, low-cost VAP prevention strategies.
Area of Science:
- Critical Care Medicine
- Infectious Diseases
- Public Health
Background:
- Ventilator-associated pneumonia (VAP) is a significant cause of mortality in hospitalized patients.
- There is a lack of systematic analysis on VAP in developing countries, including its incidence, microbiology, outcomes, and applicable interventions.
Purpose of the Study:
- To systematically analyze the incidence, microbiology, outcomes, and prevention of VAP in ventilated adults in developing countries.
- To evaluate VAP rates against National Healthcare Safety Network (NHSN) benchmarks.
- To assess the impact of VAP on intensive care unit (ICU) length of stay (LOS) and mortality.
Main Methods:
- Systematic review of MEDLINE and bibliographies for studies on VAP in developing countries (January 1966-April 2007).
- Evaluation of VAP rates using NHSN definitions.
- Assessment of VAP's impact on ICU LOS, mortality, and the effectiveness of interventions.
Main Results:
- VAP rates ranged from 10 to 41.7 per 1000 ventilator-days, generally exceeding NHSN benchmarks.
- Gram-negative bacilli were the predominant pathogens (41-92%).
- VAP was associated with crude mortality of 16%-94% and increased ICU LOS. Staff education, hand hygiene, VAP prevention guidelines, and sedation protocols showed potential for reducing VAP rates.
Conclusions:
- VAP incidence in developing countries is high, with significant negative impacts on patient outcomes.
- Few studies have reported successful VAP interventions, highlighting a need for more research.
- Future VAP prevention strategies should focus on practical, low-cost, and easily implementable measures.
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