Les pneumopathies acquises sous ventilation mécanique au CHU de Tengandogo : profil épidémiologique, clinique, bactériologique et thérapeutique

Abstract

Introduction: Ventilator-associated pneumonia (VAP) is the most common nosocomial infection in intensive care units in patients with mechanical ventilation. They are responsible for lengthening the duration of hospitalization in intensive care and an additional cost in the care of patients. Objective: To study the incidence, bacteriological and therapeutic clinical profile of VAP occurring in patients in our department. Patients and method: We conducted a prospective, descriptive observational study over a period of 10 months in the intensive care unit of the CHUT. Were included, all the patients who presented, at least 48 hours after the mechanical ventilation, a pneumonia. Results: sixty five patients had developed VAP, representing a cumulative incidence of 73.86%. The clinical signs pointing towards VAP were: fever in 90.77% of patients and purulent tracheal secretions during suction in 86.15%. The most common germs found in early VAP were: Klebsiella pneumoniae, Staphylococcus aureus and Escherichia coli. For late VAP, the most found germs were Klebsiella pneumoniae, Staphylococcus aureus and Pseudomonas Aeruginosa. Probabilistic antibiotic therapy covered germs found by bacteriology in 36% of cases for early VAP and 45% for late VAP. Conclusion: The bacterial ecology must be known in order to be able to define effective antibiotics for the adequate probabilistic treatment of VAP