The Bacterial Etiology of Early-Onset Ventilator-Associated Pneumonia in Intensive Care Units at Benghazi Medical Center

Abstract

Ventilator associated Pneumonia (VAP) poses a significant challenge in Intensive Care Units (ICUs) of several hospitals, contributing to increased mortality rates, prolonged hospital stays and elevated healthcare cost. Aim: This study aimed to estimate the incidence rate of VAP in the surgical and medical Intensive Care Units at Benghazi Medical Center (BMC) and identify the causative organisms. Methods: A retrospective matched cohort study was conducted across surgical and medical Intensive Care Units (ICUs) at Benghazi Medical Center (BMC), Libya. The study included 614 adult patients (≥18 years) admitted between July and December 2019. Data were extracted from electronic and paper-based medical records, including: - Demographics: Age, sex, admission date, ICU type. - Clinical Parameters: Ventilation duration, onset of VAP (defined as radiographic infiltrates + clinical signs [fever, purulent secretions, leukocytosis] + positive respiratory cultures after 48 hours of intubation).  - Microbiological Analysis and Antimicrobial susceptibility testing were performed. Statistical Analysis:  Data were analyzed using SPSS v.22. Categorical variables (e.g., gender, bacterial species) were expressed as frequencies/percentages; continuous variables as mean ± SD or median (IQR). Chi-square/Fisher’s exact tests compared proportions; p<0.05 was significant. Results: All early-onset VAP cases were caused by gram- negative bacteria, the most common type is klebsiella Pneumonia, then Acinetobacter Baumannii, and followed by Proteus. The highest infection rates were reported in September and November. Also, high rate of VAP was observed among males and age group between 41-60 year. Lastly, all isolated bacteria causing VAP infections were resistant to chloramphenicol, Septrin, Cefixime, Tetracycline Meropenem, Ceftriaxone, Ciprofloxacin and Azithromycin. Conclusion: To reduce VAP incidence in ICUs, medical staff must follow the evidence-based prevention and control guidelines of VAP to protect the patients as well as to decrease the mortality rate and patients stay in hospital.