Ventilator-associated pneumonia is more common in small community hospitals than in medium and large community hospitals, according to a study in Infection Control and Hospital Epidemiology.
Researchers examined the VAP rate in 31 community hospitals from 2007 to 2011. The authors defined small hospitals as having fewer than 30,000 patient-days per year, medium hospitals as having between 30,000 and 60,000 patient-days per year and large hospitals as having greater than 60,000 patient-days per year.
The overall median VAP rate was 1.4 events per 1,000 ventilator-days. Small hospitals had 2.1 VAP events per 1,000 ventilator-days — more than twice the rate at medium hospitals (0.85) and three times the rate at large hospitals (0.69). Small hospitals' increased VAP rate occurred despite their lower ventilator utilization rate, which was 0.29, compared with 0.31 for medium hospitals and 0.44 for large hospitals.
The median length of stay for VAP patients was 26 days, and 35 percent of VAP patients died during hospitalization. VAP was most frequently caused by methicillin-resistant Staphylococcus aureus at 27.9 percent, followed by Pseudomonas species at 16.3 percent and Klebsiella species at 13.3 percent.
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