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Epidemiology of Nosocomial Ventilator-Associated Pneumonia

Published online by Cambridge University Press:  21 June 2016

David L. George*
Affiliation:
Infection Control Division, Baptist Memorial Hospital, Memphis, Tennessee
*
Infection Control Div., Baptist Memorial Hospital, 899 Madison Ave., Memphis, TN 38146

Abstract

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Type
Review
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1993

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References

1. Maki, DG. Risk factors for nosocomial infection in intensive care: ‘device vs nature’ and goals for the next decade. Arch Intern Med. 1989;149:3035.CrossRefGoogle ScholarPubMed
2. Horan, TC, White, JW, Jarvis, WR, et al. Nosocomial infection surveillance, 1984. MMWR. 1986; 35(suppl 1SS):17SS29SS.Google Scholar
3. Edwards, J, Jarvis, W. The distribution of nosocomial infections by site and pathogen in adult and pediatric intensive care units in the United States, 1986-1990. Presented at the 3rd Decennial International Conference on Nosocomial Infections; July 31-Aug. 3, 1990; Atlanta, Ga.Google Scholar
4. Gross, PA, Neu, HC, Aswapokee, P, et al. Deaths from nosocomial infections: experience in a university hospital and a community hospital. Am J Med. 1980;68:219223.CrossRefGoogle Scholar
5. Haley, RW, Schaberg, DR, Crossley, KB, et al. Extra charges and prolongation of stay attributable to nosocomial infections: a prospective interhospital comparison. Am J Med. 1981;70:5158.CrossRefGoogle ScholarPubMed
6. Dixon, RE. Costs of nosocomial infections and benefits of infection control programs. In: Wenzel, RP, ed. Prevention and Control of Nosocomial Infections. Baltimore, Md: Williams and Wilkins; 1987:1925.Google Scholar
7. Wenzel, RP, Osterman, CA Hunting, KJ. Hospital-acquired infections, II: infection rates by site, service and common procedures in a university hospital. Am J Epidemiol. 1976;104:645651.CrossRefGoogle ScholarPubMed
8. Cross, AS, Roup, B. Role of respiratory assistance devices in endemic nosocomial pneumonia. Am J Med. 1981;70:681685.CrossRefGoogle ScholarPubMed
9. Haley, RW, Hooton, TM, Culver, DH, et al. Nosocomial infections in U.S. hospitals. 19751976: estimated frequency by selected character&s ofpatients. Am J Med. 1981;70:947959.CrossRefGoogle Scholar
10. Celis, R, Torres, A, Gatell, JM, et al. Nosocomial pneumonia: a multivariate analysis of risk and prognosis. Chest. 1988;93:318324.CrossRefGoogle ScholarPubMed
11. Langer, M, Mosconi, P, Cigada, M, et al. Long-term respiratory support and risk of pneumonia in critically ill patients. Am Rev Respir Dis. 1989;140:302305.CrossRefGoogle ScholarPubMed
12. Andrews, CP, Coalson, JJ, Smith, JD, Johanson, WG. Diagnosis of nosocomial bacterial pneumonia in acute, diffuse lung injury. Chest. 1981;80:254258.CrossRefGoogle ScholarPubMed
13. Bell, RC, Coalson, JJ, Smith, JD, Johanson, WG. Multiple organ system failure and infection in adult respiratory distress syndrome. Ann Intern Med. 1983;99:293298.CrossRefGoogle ScholarPubMed
14. Chastre, J, Viau, F, Brun, P, et al. Prospective evaluation of the protected specimen brush for the diagnosis of pulmonary infections in ventilated patients. Am Rev Respir Dis. 1984;130:924929.Google Scholar
15. Bryant, LR, Mobin-Uddin, K, Dillon, ML, et al. Misdiagnosis of pneumonia in patients needing mechanical respiration. Arch Surg. 1973;106:286288.CrossRefGoogle ScholarPubMed
16. Fagon, JY, Chastre, J, Hance, AJ, et al. Detection of nosocomial lung infection in ventilated patients: use of a protected specimen brush and quantitative culture techniques in 147 patients. Am Rev Respir Dis. 1988;138:110116.CrossRefGoogle ScholarPubMed
17. Mauldin, GL, Meduri, GLJ, Wunderink, RG, et al. Causes of fever and pulmonary infiltrates in mechanically ventilated patients. Am Rev Respir Dis. 1991;143:A109.Google Scholar
18. Rothman, KJ. Modern Epidemiology. Boston, Mass: Little, Brown and Co.; 1986.Google Scholar
19. Bryant, LR, Trinkle, JK, Mobin-Uddin, K, Baker, J, Griffen, WO. Bacterial colonization profile with tracheal intubation and mechanical ventilation. Arch Surg. 1972;104:647651.CrossRefGoogle ScholarPubMed
20. Zwillich, CW, Pierson, DJ, Creagh, CE, Sutton, FD, Schatz, E, Petty, TL. Complications of assisted ventilation: a prospective study of 354 consecutive episodes. Am J Med. 1974;57:161170.CrossRefGoogle ScholarPubMed
21. Lareau, SC, Ryan, KJ, Diener, CE The relationship between frequency of ventilator circuit changes and infectious hazard. Am Rev Respir Dis. 1978;118:493496.Google ScholarPubMed
22. Du Moulin, GC, Hedley-Whyte, J, Paterson, DG, et al. Aspiration of gastric bacteria in antacid-treated patients: a frequent cause of postoperative colonisation of the airway Lancet. 1982;i:242245.CrossRefGoogle Scholar
23. Mautitz, W, Graninger, W, Schindler, I, et al. Keimflora in magensaft und bronchial sekret bei langzeitbeatmeten intensivpatienten. Anaesthesist. 1985;34:203207.Google Scholar
24. Braun, SR, Levin, AB, Clark, KL. Role of corticosteroids in the development of pneumonia in mechanically ventilated head-traumavictims. Crit Care Med. 1986;14:198201.CrossRefGoogle Scholar
25. Craven, DE, Kunches, LM, Kilinsky, V, et al. Risk factors for pneumonia and fatality in patients receiving continuous mechanical ventilation. Am Rev Respir Dis. 1986;133:792796.Google ScholarPubMed
26. Rashkin, MC, Davis, T. Acute complications of endotracheal intubation: relationship to reintubation, route, urgency, and duration. Chest. 1986;89:165167.CrossRefGoogle ScholarPubMed
27. Ruiz-Santana, S, Jiminez, AG, Esteban, A, et al. ICU pneumonias: a multi-institutional study. Crit Cure Med. 1987;15:930932.CrossRefGoogle ScholarPubMed
28. Daschner, F, Kappstein, I, Schuster, F, et al. Influence of disposable (‘Conchapak’) and reusable humidifying systems on the incidence of ventilation pneumonia. J Hosp Infect. 1988;11:161168.CrossRefGoogle Scholar
29. Daschner, F, Kappstein, I, Reuschenbach, K, et al. Stress ulcer prophylaxis and ventilation pneumonia: prevention by antibacterial cytoprotective agents? Infect Control Hosp Epidemiol. 1988:9:5965.CrossRefGoogle ScholarPubMed
30. Fagon, JY, Chastre, J, Domart, Y, et al. Nosocomial pneumonia in patients receiving continuous mechanical ventilation: prospec-five analysis of 52 episodes with use of a protected specimen brush and quantitative culture techniques. Am Rev Respir Dis. 1989;139:877884.CrossRefGoogle ScholarPubMed
31. Jiminez, P, Torres, A, Rodriguez-Roisin, R, et al. Incidence and etiology of pneumonia acquired during mechanical ventilation. Crit Cure Med. 1989;17:882885.CrossRefGoogle Scholar
32. Klein, BS, Perloff, WH, Maki, DG. Reduction of nosocomial infection during pediatric intensive care by protective isolation. N Engl J Med. 1989;320:17141721.CrossRefGoogle ScholarPubMed
33. Reusser, P, Zimmerli, W, Scheidegger, D, et al. Role of gastric colonization in nosocomial infections and endotoxemia: a prospective study in neurosurgical patients on mechanical ventilation. J Infect Dis. 1989;160:414421.CrossRefGoogle ScholarPubMed
34. Deppe, SA, Kelly, JW, Thoi, LL, et al. Incidence of colonization, nosocomial pneumonia, and mortality in critically ill patients using a Trach Care closed-suction system versus an open-suction system: prospective, randomized study. Crit Care Med. 1990;18:13891393.CrossRefGoogle ScholarPubMed
35. Jacobs, S, Chang, RWS, Lee, B, Bartlett, FW. Continuous enteral feeding: a major cause of pneumonia among ventilated intensive care unit natients. I Barenter Enteral Nutr. 1990:14:353356.10.1177/0148607190014004353CrossRefGoogle Scholar
36. Torres, A, Aznar, R, Gatell, JM, et al. Incidence, risk, and prognosis factors of nosocomial pneumonia in mechanically ventilated patients. Am Rev Respir Dis. 1990;142:523528.CrossRefGoogle ScholarPubMed
37. Dreyfuss, D, Djedaini, K, Weber, P, et al. Prospective study of nosocomial pneumonia and of patient and circuit colonization during mechanical ventilation with circuit changes every 48 hours versus no change. Am Rev Respir Dis. 1991;143:738743.10.1164/ajrccm/143.4_Pt_1.738CrossRefGoogle ScholarPubMed
38. Jarvis, WR, Edwards, JR, Culver, DH, et al. Nosocomial infection rates in adult and pediatric intensive care units in the United States. Am J Med. 1991;91(suppl 3B):185S191S.10.1016/0002-9343(91)90367-7CrossRefGoogle ScholarPubMed
39. Dixon, RE. Economic costs of respiratory infections in the United States. Am J Med. 1985;78(suppl 6B):4551.CrossRefGoogle ScholarPubMed
40. Gross, PA, Antwerpen, CV. Nosocomial infections and hospital deaths. Am J Med. 1983;75:658662.CrossRefGoogle ScholarPubMed
41. Leu, HS, Kaiser, DL, Mori, M, Woolson, RF, Wenzel, RP. Hospital-acquired pneumonia: attributable mortality and morbidity. Am J Epidemiol. 1989;129:12581267.CrossRefGoogle ScholarPubMed
42. Graybill, JR, Marshall, LW, Charache, P, Wallace, CK, Melvin, VB. Nosocomial pneumonia: a continuing major problem. Am Rev Respir Dis. 1973;108:11301140.Google ScholarPubMed
43. Wenzel, RP. Hospital-acquired pneumonia: overview of the current state of the art for prevention and control. Eur J Microbiol Infect Dis. 1989;8:5660.CrossRefGoogle ScholarPubMed
44. Stevens, RM, Teres, D, Skillman, JJ, Feingold, DS. Pneumonia in an intensive care unit: a 30-month experience. Arch Intern Med. 1974;134:106111.CrossRefGoogle Scholar
45. Stamm, WE, Martin, SM, Bennett, TV. Epidemiology of nosocomial infections due to gram-negative bacilli: aspects relevant to development and use of vaccines. J Infect Dis. 1977;136(suppl):S151S160.CrossRefGoogle ScholarPubMed
46. Bartlett, TG. O'Keefe, J? Tally, FI? et al. Bacteriology of hospital-acquiredpneumonia. Arch Intern Med. 1986;146:868871.CrossRefGoogle Scholar
47. Stillwell, M, Caplan, ES. The septic multiple-trauma patient. Infect Dis Clin North Am. 1989;3:155183.CrossRefGoogle ScholarPubMed
48. Louie, M, Parker, S, Sekla, L, Nicolle, LE. Nosocomial pneumonia in a Canadian tertiary care center: a prospective surveillance study. Infect Control Hosp Epidemiol. 1991;12:356363.Google Scholar
49. Freeman, I. Rosner, BA. McGowan, JE. Adverse effects of nosocomial infection. J Infect Dis. 1979;140:732740.CrossRefGoogle ScholarPubMed
50. Craig, CP, Connelly, S. Effect of intensive care unit nosocomial pneumonia on duration of stay and mortality, Am J Infect Control. 1984;12:233238.CrossRefGoogle ScholarPubMed
51. Pinner, RW, Haley, RW, Blumenstein, BA, Schaberg, DR, Von Allmen, SD, McGowan, JE. High cost of nosocomial infections, Infect Control. 1982;3:143149.CrossRefGoogle ScholarPubMed
52. Boyce, JM, Potter-Bynoe, G, Dziobek, L, Solomon, SL. Nosocomial pneumonia in Medicare patients: hospital costs and reimbursement patterns under the prospective payment system. Arch Intern Med. 1991;151:11091114.CrossRefGoogle ScholarPubMed
53. Schaberg, DR, Culver, DH, Gaynes, RR Major trends in the microbial etiology of nosocomial infection. Am J Med. 1991;91(suppl 3B):72S75S.CrossRefGoogle ScholarPubMed
54. Higuchi, JH, Coalson, JJ, Johanson, WG. Bacteriologie diagnosis of nosocomial pneumonia in primates: usefulness of the protected specimen brush. Am Rev Respir Dis. 1982:125:5357.Google Scholar
55. Torres, A, De La Bellacasa, JP, Xaubet, A, et al. Diagnostic value of quantitative cultures of bronchoalveolar lavage and telescoping plugged catheters in mechanically ventilated patients with bacterial pneumonia. Am Rev Respir Dis. 1989; 140:306310.10.1164/ajrccm/140.2.306CrossRefGoogle ScholarPubMed
56. Flynn, DM, Weinstein, RA, Nathans, C, Gaston, MA, Kabins, SA. Patients' endogenous flora as the source of nosocomial Entero-bacter'm cardiac surgery. J Infect Dis. 1987;156:363368.CrossRefGoogle Scholar
57. Roig, J, Aguilar, X, Ruiz, J, et al. Comparative study of Legionella pneumophila and other nosocomial-acquired pneumonias. Chest. 1991;99:344350.CrossRefGoogle ScholarPubMed
58. Rhame, FS, Streifel, AJ, Kersey, JH, McGlave, PB. Extrinsic risk factors for pneumonia in the patient at high risk of infection. Am J Med. 1984;76 (suppl):4252.CrossRefGoogle ScholarPubMed
59. Arnow, PM, Andersen, RL, Mainous, PD, Smith, EJ. Pulmonary aspergillosis during hospital renovation. Am Rev Respir Dis. 1978;118:4953.Google Scholar
60. Arnow, PM, Sadigh, M, Costas, C, Weil, D, Chudy, R. Endemie and epidemic aspergillosis associated with in-hospital replication of Aspergillus organisms. J Infect Dis. 1991;164:9981002.CrossRefGoogle Scholar
61. Suspected nosocomial influenza cases in an intensive care unit-Georgia. MMWR. 1988;37:39.Google Scholar
62. Sanderson, PJ. The sources of pneumonia in ITU patients. Infect Control. 1986;7:104106.Google ScholarPubMed
63. Elpern, EH, Jacobs, ER, Bone, RC. Incidence of aspiration in tracheally intubated adults. Heart Lung. 1987;16:527531.Google ScholarPubMed
64. Dixon, RE. Nosocomial respiratory infections. Infect Control. 1983;4:376381.CrossRefGoogle ScholarPubMed
65. Spray, SB, Zuidema, GD, Cameron, JL. Aspiration pneumonia: incidence of aspiration with endotracheal tubes. Am J Surg. 1976;131:701703.CrossRefGoogle ScholarPubMed
66. Schwartz, SN, Dowling, JN, Benkovic, C, DeQuittner-Buchanan, M, Prostko, T, Yee, RB. Sources of gram-negative bacilli colonizing the tracheae of intubated patients. J Infect Dis. 1978;138:227231.CrossRefGoogle ScholarPubMed
67. Wynne, JW, Modell, JH. Respiratory aspiration of stomach contents. Ann Intern Med. 1977;87:466474.10.7326/0003-4819-87-4-466CrossRefGoogle ScholarPubMed
68. Atherton, ST, White, DJ Stomach as source of bacteria colonising respiratory tract during artificial ventilation. Lancet. 1978;ii:968969.CrossRefGoogle Scholar
69. Pingleton, SK, Hinthorn, DR, Liu, C. Enteral nutrition in patients receiving mechanical ventilation: multiple sources of tracheal colonization include the stomach. Am J Med. 1986;80:827832.CrossRefGoogle ScholarPubMed
70. Humphrey, MA, Simpson, GT, Grindlinger, GA. Clinical characteristics of nosocomial sinusitis. Ann Otot Rhinol Laryngol. 1987;96:687690.CrossRefGoogle ScholarPubMed
71. Guerin, JM, Meyer, P, Barbotin-Larrieu, E Habib, Y. Nosocomial bacteremia and sinusitis in nasotracheally intubated patients in intensive care. Rev Infect Dis. 1988;10:12261227.CrossRefGoogle ScholarPubMed
72. Guerin, JM, Meyer, P Reizine, D, Levy, C. Search for purulent rhinosinusitis in intensive care unit patients with nosocomial pulmonary infections. Crit Care Med. 1988;16:914915.CrossRefGoogle ScholarPubMed
73. Rachelefsky, GS, Katz, RM, Siegel, SC. Chronic sinus disease with associated reactive airway disease in children. Pediatrics. 1984;73:526529.CrossRefGoogle ScholarPubMed
74. Umetsu, DU, Moss, RB, King, W, Lewiston, J. Sinus disease in patients with severe cystic fibrosis: relation to pulmonary exacerbation Lancet. 1990;335:10771078.CrossRefGoogle ScholarPubMed
75. Quinn, LH, Meyer, OO. The relationship of sinusitis and bronchiectasis. Arch Otolaryngol. 1929;10:152165.CrossRefGoogle Scholar
76. Reinarz, JA, Pierce, AK, Mays, BB, et al. The potential role of inhalation therapy equipment in nosocomial pulmonary infection. J Clin Invest. 1965;44:831839.CrossRefGoogle ScholarPubMed
77. Comhaire, A, Lamy, M. Contamination rate of sterilized ventilators in an intensive care unit. Crit Care Med. 1981;9:546548.CrossRefGoogle Scholar
78. Craven, DE, Lichtenberg, DA, Goularte, TA, et al. Contaminated medication nebulizers in mechanical ventilator circuits: source of bacterial aerosols. Am J Med. 1984;77:834838.CrossRefGoogle ScholarPubMed
79. Craven, DE, Goularte, TA, Make, BJ. Contaminated condensate in mechanical ventilator circuits: a risk factor for nosocomial pneumonia. Am Rev Respir Dis. 1984;129:625628.Google ScholarPubMed
80. Sottile, FD, Marrie, TJ, Prough, DS, et al. Nosocomial pulmonary infection: possible etiologic significance of bacterial adhesion to endotracheal tubes, Crit Care Med. 1986;14:265270.CrossRefGoogle ScholarPubMed
81. Irwin, RS, Demers, RR, Pratter, MR, et al. An outbreak of Acinetobacter infection associated with the use of a ventilator Spirometer. Respir Care. 1980;25:232237.Google ScholarPubMed
82. Weber, DJ, Wilson, B, Rutala, WA, Thomann, CA. Manual ventilation bags as a source for bacterial colonization of intubated patients. Am Rev Respir Dis. 1990;142:892894.CrossRefGoogle ScholarPubMed
83. Kappstein, I, Schulgen, G, Friedrich, T, et al. Incidence of pneumonia in mechanically ventilated patients treated with sucralfate or cimetidine as prophylaxis for stress bleeding: bacterial colonization of the stomach. Am J Med. 1991;91(2A):125S131s.CrossRefGoogle ScholarPubMed
84. Tryba, M. Risk of acute stress bleeding and nosocomial pneumonia in ventilated intensive care unit patients: sucralfate versus antacids. Am J Med. 1987;83(3B):117124.CrossRefGoogle ScholarPubMed
85. Tryba, M. Prevention of stress bleeding with ranitidine or pirenzipine and the risk of pneumonia. J Clin Anaesthesia. 1988;1:1220.CrossRefGoogle ScholarPubMed
86. Coppolo, DP, May, JJ. Self-extubations: a 12-month experience. Chest. 1990;98:165169.CrossRefGoogle ScholarPubMed
87. Little, LA, Koenig, JC, Newth, CJL. Factors affecting accidental extubations in neonatal and pediatric intensive care patients. Crit CareMed. 1990;18:163165.CrossRefGoogle ScholarPubMed
88. Flaherty, J, Nathan, C, Kabins, SA, et al. Pilot trial of selective decontamination for prevention of bacterial infection in an intensive care unit. J Infect Dis. 1990;162:13931397.CrossRefGoogle Scholar
89. Simmons, BP, Wong, ES. Guidelines for the prevention of nosocomial pneumonia. Am J Infect Control. 1983;11:230243.CrossRefGoogle Scholar