Clinical profile of ventilator-associated pneumonia and its correlation between risk factor, morbidity and mortality in children

Background: Mechanical ventilation (MV) is often necessary to manage critically ill pediatric patients admitted in the ICU. Nonetheless, it presents certain complications, including the potential risk of developing ventilator-associated pneumonia (VAP). The main objective of the present study was to evaluate the clinical profile and risk factor associated with the morbidity and mortality in children with VAP. Methods: This was a cross-sectional observational study conducted on 120 children aged 1 month 12 years who were mechanically ventilated. All enrolled children were evaluated daily for the onset of ventilator-associated pneumonia (VAP). Chest radiography and microbiological sampling was performed in children suspected with VAP. Duration of hospital stays, ventilator days and reintubation were also recorded. Results: Out of 120 children, 35 (29.2%) had developed VAP and the prevalence of VAP is estimated to be 29.2%. The most prevalent pathogen associated with VAP was K. pneumonia in 18 (51.4%) of the children. The duration of MV (28.65±12.76 vs 9.87±6.87, p<0.001 and hospital stay (35.87±8.15 vs 15.76±4.12; p=0.001) was higher in VAP as compared to no VAP and it was significant. Bivariate analysis revealed that use of steroids (p=0.004), sedative (p=0.01) and reintubation (p=0.003) was found to be significant risk factor for the development of VAP. The incidence of mortality in VAP was 4/35, i.e., 11.4%. Conclusions: About one-third of the children developed VAP. Klebsiella was the most predominate isolate and duration of MV and hospital stay were important predictors for VAP.