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Abstract Mechanically ventilated children are at a high risk of nosocomial infections, including ventilator-associated pneumonia (VAP). Children who develop VAP have an increased risk of mortality and morbidities such as prolonged intubation and intensive care unit (ICU) stays and the need for extensive rehabilitation. VAP is the most common nosocomial infection in mechanically ventilated patients, occurring in up to 32% of pediatric ICU (PICU) patients who require mechanical ventilation (MV) for more than 24 hours. VAP is associated with a 2-fold to 3-fold increase in mortality in ventilated children and it increases total hospitalization costs and resource utilization, increasing duration of MV by 5 to 11 days and PICU length of stay by 11 to 34 days. The suspicion and/or the diagnosis of VAP remains a primary reason for antibiotic administration in the PICU. Thus, VAP remains a significant obstacle to the management of pediatric critical illnesses and injuries. Limited understanding of the microbial and host factors associated with VAP pathogenesis has precluded development of truly effective prevention and treatment strategies. The aim of the present study was to evaluate the incidence, risk factors, and outcome of VAP. This prospective observational study included children from 1 month to 18 years old who were mechanically ventilated in PICU. Children were clinically evaluated and monitored for VAP development which was diagnosed according to CDC criteria. Patients who developed VAP were compared with those who did not develop VAP regarding VAP risk factors and outcome. 76 mechanically ventilated children were recruited. 40.8% of them developed VAP. VAP incidence was 38.3 episodes 1000 days. Pediatric Risk of Mortality (PRISM), Multiple Organ Dysfunction Syndrome (MODS), Glasgow Coma Scale (GCS), and transfusions of blood products were significantly higher among children who developed VAP compared with those without VAP. (P=0.016, 0.027, 0.005, and 0.002 respectively). VAP was associated with higher mortality rate, length of PICU stay ,and MV duration . (P=0.004, 0.009.and <0.001 respectively).VAP was an independent predictor of mortality after adjustment of PRISM,MODS .Adjusted Odds Ratio(OR)95%=4.07Confidence Interval(CI)=(1.15-14.35).VAP is very common among mechanically ventilated children. VAP was associated with increased length of PICU stay, higher mortality, and MV duration .Risk factors of VAP included MODS, PRISM, transfusions of blood products and GCS. |