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©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
Causative bacteria of ventilator-associated pneumonia in intensive care unit in Bahrain: Prevalence and antibiotics susceptibility pattern
Mohamed Eliwa Hassan, Safaa Abdulaziz Al-Khawaja, Nermin Kamal Saeed, Sana Abdulaziz Al-Khawaja, Mahmood Al-Awainati, Sara Salah Yusuf Radhi, Mohamed Hameed Alsaffar, Mohammed Al-Beltagi
Mohamed Eliwa Hassan, Sana Abdulaziz Al-Khawaja, Sara Salah Yusuf Radhi, Mohamed Hameed Alsaffar, Intensive Care Unit, Department of Internal medicine, Salmaniya Medical Complex, Ministry of Health, Manama, Kingdom of Bahrain, Manama 12, Manama, Bahrain
Safaa Abdulaziz Al-Khawaja, Infectious Disease Unit, Department of Internal Medicine, Salmaniya Medical Complex, Ministry of Health, Kingdom of Bahrain, Manama 12, Manama, Bahrain
Nermin Kamal Saeed, Medical Microbiology Section, Department of Pathology, Salmaniya Medical Complex, Ministry of Health, Kingdom of Bahrain, Manama 12, Manama, Bahrain
Nermin Kamal Saeed, Medical Microbiology Section, Department of Pathology, Irish Royal College of Surgeon, Bahrain, Busiateen 15503, Muharraq, Bahrain
Mahmood Al-Awainati, Department of Family Medicine, Ministry of Health, Manama, Kingdom of Bahrain, Manama 12, Manama, Bahrain
Mohammed Al-Beltagi, Department of Pediatrics, Faculty of Medicine, Tanta University, Tanta 31511, Alghrabia, Egypt
Mohammed Al-Beltagi, Department of Pediatrics, University Medical Center, King Abdulla Medical City, Arabian Gulf University, Dr. Sulaiman Al Habib Medical Group, Manama 26671, Manama, Bahrain
Author contributions: Hassan ME, Al-Khawaja S, and Radhi SSY designed the study; Hassan ME, Radhi SSY, Al-Awainati M, and Alsaffar M collected and analyzed data; Saeed NK performed microbiological testing, data, and analysis; Hassan ME wrote the manuscript draft; Al-Beltagi M wrote, revised, and edited the final draft; All authors have read and approved the manuscript and take full responsibility for the study.
Institutional review board statement: The study was ethically approved by the Research and Research Ethics Committee for Governmental Hospitals, Salmaniya Medical Complex, Bahrain.
Informed consent statement: Consent was unnecessary as the study was observational without exposure to the patient’s data.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at mbelrem@hotmail.com. Participants gave informed consent for data sharing. No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Mohammed Al-Beltagi, MBChB, MD, MSc, PhD, Academic Editor, Chairman, Consultant Physician-Scientist, Professor, Researcher, Department of Pediatrics, Faculty of Medicine, Tanta University, Al Bahr Street, Tanta 31511, Alghrabia, Egypt. mbelrem@hotmail.com
Received: December 23, 2022
Peer-review started: December 23, 2022
First decision: January 31, 2023
Revised: February 3, 2023
Accepted: March 24, 2023
Article in press: March 24, 2023
Published online: June 9, 2023
ARTICLE HIGHLIGHTS
Research background
Ventilator-associated pneumonia (VAP) is the most common infection encountered among intubated patients, occurring in 10%-30% of mechanically ventilated patients.
Research motivations
The lack of data from the Kingdom of Bahrain stimulated us to investigate VAP incidence, risk factors, and microbial profiles in the central hospital in the kingdom.
Research objectives
We aimed to define VAP incidence in the intensive care unit (ICU) at Salmaniya Medical Complex and review the risk factors and the predominant pathogens that cause VAP to choose the appropriate empiric antimicrobial therapy for VAP-related sepsis in adult ICU.
Research methods
The study was a prospective, observational, cross-sectional study done between November 2019 to June 2020 to determine the microbiological profile in adult patients with VAP and evaluate the magnitude of multidrug-resistant (MDR) microbes among those patients. We used patients who needed mechanical ventilation and did not develop VAP as a control group. We included adult and adolescent patients (> 14 years old) who were admitted to the ICU and required intubation and mechanical ventilation.
Research results
The incidence of VAP was 29.7% during the study period, with a calculated VAP rate of 22.14 events per 1000 ventilator days and a mean age of 52 years ± 20. Most VAP cases had late-onset VAP with a mean number of ICU days before the development of VAP of 9.96 ± 6.55. Gram-negative contributed to most VAP cases in our unit, with MDR Acinetobacter being the most identified pathogen.
Research conclusions
The VAP rate in our ICU was relatively high compared to the international benchmark.
Research perspectives
The high VAP rate in our hospital triggered us to initiate a vital action plan to reinforce the implementation of the VAP prevention bundle.
