Infection control


Ventilator-associated pneumonia (VAP) is one of the common and deadly respiratory tract infections. Affecting patients who are already critically ill in hospital settings, it can worsen already grave outcomes. So how can hospitals work to prevent and treat this infection? Abi Millar speaks to Freya Harrison, a microbiologist working in the School of Life Sciences at the University of Warwick, to fi nd out why VAP is so hard to treat and how patients might benefi t from the latest research advances.


entilator-associated pneumonia (VAP) is a common menace within intensive care wards. Affecting around 20% of critically ill patients, this is a serious lung infection that can occur after a person has been on a ventilator for 48 hours. Estimating its mortality rate can be tricky – this is a patient pool who, after all, are already sick enough to be intubated. However, we know that it increases the average length of hospital stay by around four to nine days, and that it bumps up treatment costs by around £9,000 per patient. It also accounts for around half of all antibiotic use within the ICU, as doctors aim to halt the spread of bacteria. While VAP is far from a new problem,


awareness grew significantly during the peak of the Covid-19 pandemic. Many mechanically ventilated patients, who were in the ICU for severe Covid-19, subsequently contracted VAP as well. Not surprisingly, this was associated with even worse outcomes. In one study of 1,424 ventilated patients, 231 had VAP episodes. Among those without VAP, 44.7% died within 60 days, compared to 47.6% of those who had contracted an additional infection.


Breathe easy V


“This underlines the point that people who are put on mechanical ventilation tend to be very sick to start with,” remarks Dr Freya Harrison, a microbiologist working in the School of Life Sciences at the


20 Practical Patient Care / www.practical-patient-care.com


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