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Evaluation of the New Centers for Disease Control and Prevention Ventilator-Associated Event Module and Criteria in Critically Ill Children in Greece

Published online by Cambridge University Press:  11 July 2016

Elias Iosifidis ,
Elpis Chochliourou ,
Asimenia Violaki ,
Elisavet Chorafa ,
Stavroula Psachna ,
Afroditi Roumpou ,
Maria Sdougka  and
Emmanuel Roilides
Elias Iosifidis
Affiliation:
Infectious Diseases Unit, 3rd Department of Pediatrics, Aristotle University School of Medicine, Hippokration Hospital, Thessaloniki, Greece
Elpis Chochliourou
Affiliation:
Pediatric Intensive Care Unit, Hippokration Hospital, Thessaloniki, Greece
Asimenia Violaki
Affiliation:
Pediatric Intensive Care Unit, Hippokration Hospital, Thessaloniki, Greece
Elisavet Chorafa
Affiliation:
Infectious Diseases Unit, 3rd Department of Pediatrics, Aristotle University School of Medicine, Hippokration Hospital, Thessaloniki, Greece
Stavroula Psachna
Affiliation:
Infectious Diseases Unit, 3rd Department of Pediatrics, Aristotle University School of Medicine, Hippokration Hospital, Thessaloniki, Greece
Afroditi Roumpou
Affiliation:
Infectious Diseases Unit, 3rd Department of Pediatrics, Aristotle University School of Medicine, Hippokration Hospital, Thessaloniki, Greece
Maria Sdougka
Affiliation:
Pediatric Intensive Care Unit, Hippokration Hospital, Thessaloniki, Greece
Emmanuel Roilides*
Affiliation:
Infectious Diseases Unit, 3rd Department of Pediatrics, Aristotle University School of Medicine, Hippokration Hospital, Thessaloniki, Greece
*
Address correspondence to Emmanuel Roilides, MD, PhD, FIDSA, FAAM, 3rd Department of Pediatrics, Hippokration Hospital, Konstantinoupoleos 49, GR-546 42 Thessaloniki, Greece (roilides@med.auth.gr).
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Abstract

OBJECTIVE

To evaluate the new adult Centers for Disease Control and Prevention (CDC) ventilator-associated event (VAE) module in critically ill children and compare with the traditionally used CDC definition for ventilator-associated pneumonia (VAP).

DESIGN

Retrospective observational study of mechanically ventilated children in a pediatric intensive care unit in Greece January 1-December 31, 2011.

METHODS

Assessment of new adult CDC VAE module including 3 definition tiers: ventilator-associated condition (VAC), infection-related VAC, and possible/probable ventilator-associated pneumonia (VAE-VAP); comparison with traditional CDC criteria for clinically defined pneumonia in mechanically ventilated children (PNEU-VAP). We recorded Pediatric Risk of Mortality score at admission (PRISM III), number of ventilator-days, and outcome.

RESULTS

Among 119 patients with mechanical ventilation (median [range] number of ventilator-days, 7 [1–183]), 19 patients experienced VAC. Criteria for VAE-VAP were fulfilled in 12 of 19 patients with VAC (63%). Children with either VAC or VAE-VAP were on ventilation more days than patients without these conditions (16.5 vs 5 d, P=.0006 and 18 vs 5 d, P<.001, respectively), whereas PRISM-III score was similar between them. Mortality was significant higher in patients with new VAE-VAP definition (50%), but not in patients with VAC (31.6%), than the patients without new VAE-VAP (14%, P=.007) or VAC (15%, P=.1), respectively. No significant association was found between PNEU-VAP and death. Incidences of PNEU-VAP and VAE-VAP were similar, but the agreement was poor.

CONCLUSIONS

VAE-VAP and PNEU-VAP found similar prevalence in critically ill children but with poor agreement. However, excess of death was significantly associated only with VAE-VAP.

Infect Control Hosp Epidemiol 2016:1–5

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 37 , Issue 10 , October 2016 , pp. 1162 - 1166
Copyright
© 2016 by The Society for Healthcare Epidemiology of America. All rights reserved 

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Footnotes

Presented in part: 32nd Annual Meeting of the European Society for Paediatric Infectious Diseases; Dublin, Ireland; May 6–10, 2014. ESPID-0814, Short Oral Presentation 5: Infection Control & Diagnostics (OS05).

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