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Publishing House Zaslavsky, Trauma, 3(16), p. 202-206

DOI: 10.1177/1460408614532622

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Reduced incidence of methicillin-resistant Staphylococcus aureus ventilator-associated pneumonia in trauma patients: A new insight into the efficacy of the ventilator care bundle

This paper was not found in any repository, but could be made available legally by the author.
This paper was not found in any repository, but could be made available legally by the author.

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Abstract

Introduction: There has been a dramatic recent increase in the incidence of ventilator-associated pneumonia caused by methicillin-resistant Staphylococcus aureus. We investigated the effect of implementation of a ventilator care bundle on the incidence of ventilator-associated pneumonia in a cohort of trauma patients. Methods: A ventilator care bundle was implemented after a 7-month baseline period. Ventilator-associated pneumonia rates, rates of methicillin-resistant Staphylococcus aureus acquisition, rates of vancomycin administration, intensive care unit lengths of stay, and durations of mechanical ventilation were prospectively recorded for 10 months. Results: Use of a ventilator care bundle was associated with a reduced incidence of ventilator-associated pneumonia from 42 cases per 1000 ventilator days (95% confidence interval: 17–83) in the pre-intervention group to 19 (95% confidence interval: 11–34) cases per 1000 ventilator days in the post-intervention group ( p = 0.04). The rate of methicillin-resistant S. aureus acquisition was significantly different in the pre-intervention group (27%) and the post-intervention group (3.9%) ( p < 0.001). Relative to the pre-intervention period, there was a significant reduction in the duration of mechanical ventilation ( p = 0.03) and length of intensive care unit stay during the post-intervention period ( p = 0.015). Conclusion: The incidence of methicillin-resistant S. aureus-ventilator-associated pneumonia in trauma patients could be reduced by implementation of a ventilator care bundle.