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

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.