The Science Journal of the American Association for Respiratory Care

2008 OPEN FORUM Abstracts

VENTILATOR ASSOCIATED PNEUMONIA (VAP) IN KOREAN ICUS

Kook-Hyun Lee1, Jong Min Kim1, Konis Group1



Background: Jong Min Kim, D.V.M.*, Kookhyun Lee, M.D*., KONIS group Clinical Research Institute, Seoul National University Hospital*
Korea has 43 university hospitals. Each university hospital has about 50 ICU beds. ICU beds includes about 5 % of hospital beds. But only 36 % of ICUs have intensivists and 40 % of ICU patients use a ventilator. Nurse to Patient ratio are 1:3.4. Respiratory therapy profession is undeveloped. Anesthesiologists are mainly served in ICUs. Physicians and nurses use their own methods by their own experiences, and want to be specialists in that field.

Methods: A survey was conducted for the 44 hospitals participating in The Korean Nosocomial Infections Surveillance System (KONIS) and the data were rechecked by the KONIS hospitals through KONIS web-network. The survey included questions about hospital bes, infection control personnel, and microbiologic laboratory.

Results: The Korean Society for Nosocomial Infection Control (KOSNIC) surveyed VAP at 76 ICUs in 2006. Among 235 nosocomial pneumonia cases, 161 VAP were identified. The ventilator utilization rate in ICUs was 0.41. The VAP rate was 3.80 cases per 1,000 device days. VAP rate was highest in the neurosurgical ICUs. S. aureus was most prevalent in pneumonia cases with specific laboratory findings. 88.7 %. of S. aureus was methicillin resistant. However, in clinically defined pneumonia, gram negative bacilli (63.2 %) were most common, listed by frequency as P. aeruginosa, A. Baumannii and K. pneumoniae.

Conclusion: In Korean ICUs, semi-recumbent position, supraglottic suctioning and early extubation with a noninvasive ventilatory support are currently tried for intubated patients to lower the possibility of VAP. VAP continue to be an important issue. From the simple hand hygiene to complex microbiology, as well as international data network, multidisciplinary approach is required for a successful program.

1. Lee SO et al. Korean nosocomial infection surveillance system (KONIS) reports: data summary from July through September 2006. Hospital Infection 2006:11(2)113-128

2. Branson RD, Kollef MH. Ventilator-Associated Pneumonia. Respiratory Care 2005 50(6):712-713