Related Experiment Video

Updated: Jul 5, 2026

Murine Oropharyngeal Aspiration Model of Ventilator-associated and Hospital-acquired Bacterial Pneumonia
04:32

Murine Oropharyngeal Aspiration Model of Ventilator-associated and Hospital-acquired Bacterial Pneumonia

Published on: June 28, 2018

Risk factors and microbiological characteristics of ventilator-associated pneumonia in a Tunisian intensive care unit

Hallouma Ben Fredj1, Saida Sakhri2, Abdelmajid Hafyene1

  • 1Department of Anesthesia and Intensive Care Unit, Charles Nicolle Hospital, Tunis, Tunisia.

Respiratory Medicine
|July 3, 2026
PubMed
Abstract

Insights

Ventilator-associated pneumonia (VAP) in intensive care units (ICUs) is linked to significant risks, especially with multidrug-resistant (MDR) organisms. This study identified key risk factors and high mortality rates in a Tunisian ICU during the COVID-19 pandemic.

Area of Science:

  • Infectious Diseases
  • Critical Care Medicine
  • Epidemiology

Background:

  • Ventilator-associated pneumonia (VAP) poses a significant threat in intensive care units (ICUs), particularly in regions like North Africa with a high prevalence of multidrug-resistant (MDR) organisms.
  • The COVID-19 pandemic introduced unique challenges and altered patient populations within ICUs, potentially impacting VAP epidemiology.

Purpose of the Study:

  • To investigate the incidence, risk factors, microbiological characteristics, and outcomes of VAP in a Tunisian tertiary ICU.
  • To analyze these factors within the specific context of the COVID-19 pandemic.

Main Methods:

  • A retrospective observational study involving 422 mechanically ventilated patients.
  • VAP diagnosis utilized modified Johanson criteria.
  • Multivariable logistic regression was employed to identify independent risk factors, adhering to STROBE guidelines.

Main Results:

  • VAP incidence was 24.2% (6.2 per 1,000 ventilator-days), with a median onset of 8 days post-intubation.
  • Independent risk factors included polytrauma, intrahospital transport, diabetes, male sex, and age > 75 years.
  • A high proportion (59%) of Gram-negative bacilli isolates were MDR, notably *Acinetobacter baumannii* and *Klebsiella pneumoniae*. Prior antibiotic exposure correlated with MDR infections. ICU and hospital mortality rates were 40% and 44%, respectively.

Conclusions:

  • VAP in this pandemic-era ICU cohort was associated with substantial morbidity, mortality, and a high burden of MDR Gram-negative pathogens.
  • ICU-specific risk factors and prior antibiotic use were critical contributors.
  • Findings are specific to a COVID-19-dominated ICU setting and may not be generalizable to non-pandemic periods.
Keywords:
Empiric antibiotic therapyGram-negative bacilliIntensive care unitMultidrug resistanceVentilator-associated pneumonia

More Related Videos

Following in Real Time the Impact of Pneumococcal Virulence Factors in an Acute Mouse Pneumonia Model Using Bioluminescent Bacteria11:32

Following in Real Time the Impact of Pneumococcal Virulence Factors in an Acute Mouse Pneumonia Model Using Bioluminescent Bacteria

Published on: February 23, 2014

Related Concept Videos

Pneumonia I: Introduction01:30

Pneumonia I: Introduction

Pneumonia is an acute respiratory infection that targets the lungs, specifically the alveoli. These tiny air sacs, essential for oxygen exchange, become engorged with pus and fluid, severely hindering breathing, decreasing oxygen absorption, and causing significant pain and discomfort during respiration.
Risk Factors
Various factors influence the likelihood of developing pneumonia. Age plays a crucial role, with infants, children under two, and individuals over 65 at increased risk due to their...
Pneumonia I: Introduction01:29

Pneumonia I: Introduction

Pneumonia is an infection of the lower respiratory tract that leads to inflammation of the lung parenchyma, often resulting in the accumulation of inflammatory exudate in the alveoli and airways. Unlike the watery, low-protein fluid exudate in pulmonary edema, the exudate in this case is a thick fluid rich in immune cells, proteins, and debris produced during infection and inflammation.This impairs gas exchange and can lead to consolidation of lung tissue. The infection may be caused by a...
Factors Affecting the Risk of Infection01:26

Factors Affecting the Risk of Infection

The hosts' susceptibility to infection depends on several factors. The integrity of the skin and mucous membranes helps protect the body against microbial attacks. When the skin is altered, the chance of infection, limb loss, and even death increases.
The integrity and count of the white blood cells help the body resist pathogens and fight infection. When impaired, it reduces the body's resistance to pathogens. The acidic pH levels of the gastrointestinal, genitourinary tracts, and skin create...
Pneumonia III: Complications and Assessment01:30

Pneumonia III: Complications and Assessment

Pneumonia poses the potential for numerous complications that warrant consideration. These complications include the following:
Pneumonia II: Pathophysiology01:29

Pneumonia II: Pathophysiology

The pathophysiology of pneumonia involves the following steps:
Pneumonia V: Nursing management and Prevention01:30

Pneumonia V: Nursing management and Prevention

Nursing management of pneumonia involves promoting airway patency, facilitating rest and conserving energy, encouraging fluid intake, maintaining nutrition, and educating patients.
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed.