Objective: 1) Determine the ventilator-associated pneumonia (VAP) occurrence rate, duration time to develop VAP, the microorganisms causing VAP, and mortality rate of VAP patients. 2) Analyze the factors related to VAP among patients’ characteristics, underlying diseases, and APACHE II score. 3) Analyze the risk factors to VAP and risk factors that cause death in VAP patients.

Materials and Methods: A prospective observational study of patients aged more than 15 years, who were on a mechanical ventilator for more than two calendar days, hospitalized at King Narai Hospital, Lopburi Province, Thailand between April and July 2016. Data were analyzed through descriptive and inferential statistics using an SPSS program.

Results: Among the 307 patients that underwent mechanical ventilation for more than two calendar days, 169 patients were male (55.05%). The mean age was 61.74 years (SD 18.42). Patients with DM, IHD or CHF, CKD, COPD, and CVA were 23.78%, 14.66%, 10.75%, 9.45%, and 8.14%, respectively. The mean APACHE II score was 19.34 (SD 5.15). Out of 307 patients, 88 cases (28.7%) developed VAP. The incident rate was 13.65 occurrences per 1,000 days. The mean duration time for VAP was 10.52 days (SD 8.23). The mean ventilation days were 18.43 (SD 15.98). The majority of VAP or 72 cases (69.32%) was caused by Acinetobacter baumannii XDR, which was pan drugs-resistant and resisted to all antibiotic groups except tigecyclin and colistin, resulting in the death of 62.5% of VAP patients. If analyzed in all intubated groups, the mortality rate from VAP was 17.9% in all patients that received mechanical ventilation. The risk factors for VAP, which was statistically significant at p-value smaller than 0.01, were treated with nebulizer, duration time on ventilator, drowsy, and semi-coma patients. At p-value smaller than 0.05 were APACHE II score, stuporous patients, senility, or bed ridden patients.

Conclusion: The incident rate of VAP in King Narai Hospital was 13.65 occurrences per 1,000 days, and the mortality rate from VAP was 62.5%. The majority of VAP (69.32%) was caused by A. baumannii XDR. The significant risk factors that had effect on mortality from VAP were treated with nebulizers, the duration time on the ventilator, high APACHE II score, consciousness condition (stupor and semi-coma).

Keywords: Ventilator associated pneumonia (VAP), Risk factor, APACHE II score, King Narai Hospital