Ventilator-associated event (VAE) epidemiology and prognosis: Preliminary results of VAE-Türkiye

To determine incidences, risk factors and outcomes of VAE in Türkiye. Patients and methods The multicenter study was planned in 21 centers that have prospective, active surveillance of VAE. The data obtained from infection control committee surveillance reports. Adult patients who had been on mechanical ventilation for more than 48 h were eligible and patients were followed up daily for 30 days. Centers that followed at least 50-ventilated patients were included. Only the first episode of VAE in each patient was included in the study. VAE definitions based on 2015 CDC update (Fig. 1).In this preliminary study, a total of 324 patients from five center were included. VAE was seen in 50 patients (15.4%, 6.09/1000 ventilator days). Clinical characteristics of VAE and Non-VAE patients were similar (p > 0.05) (Table 1). Central venous catheter was used with a higher frequency in patients with VAE than Non-VAE (92% vs. 75%) and healthcare associated infection was higher during hospitalization (68% vs. 25%). Antibiotics were used for a reason other than VAE in a total of 241 (74%) patients.The characteristics of the VAE group are presented in Table 2. Infection-Related Ventilated Complication plus (IVAC-plus) episodes were the main reason of VAE 32 (64.0%) and Ventilator-Associated Condition (VAC) accounted for 18 (36.0%) VAE episodes. Twenty-five (78.1%) out of 32 IVAC-plus met the criteria for probable ventilator-associated pneumonia (PVAP). Ventilator-Associated Pneumonia (VAP) developed in 41 patients, 26 of whom (63.0%) fit the definition of a concurrent VAE. The median days from MV onset to VAE was 10.5 (2–70). PVAP was monomicrobial in 21 (65.6%) and polymicrobial in 4 (12.5%) patients. The most frequently identified bacteria was Acinetobacter baumannii (43.8%) and all the causative agents were multidrug-resistant (MDR). In the VAE group, clinical response was obtained in 21 (42%) patients at the fifth day of antibiotic therapy and microbiological response was obtained in 25 (50%) patients. Mortality was higher in VAE patients than Non-VAE (64% vs.46%). Conclusion This is the first multicenter VAE epidemiology study in Türkiye. VAE is a common complication in intubated patients with high mortality and high rates of MDR