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A multicentre prospective cohort study was performed in 17 intensive care units (ICUs) in
tertiary care hospitals in Hubei Province, China. Ventilator-associated pneumonia (VAP) was
defined according to modified criteria from the published literature. Among 4155 ventilated
patients, the crude incidence and incidence rate of VAP were 20.9% and 28.9 cases per 1000
ventilator-days. Multivariate analysis using logistic regression revealed risk factors including
male sex [risk ratio (RR): 1.5; P < 0.001], coma (RR: 2.1; P< 0.001), chronic obstructive
pulmonary disease (RR: 1.4; P < 0.001), infections at other sites (RR: 1.6; P ¼0.001), serious
disease predating the onset of VAP (RR: 1.6; P< 0.001) and interventions including antacid
treatment (RR: 1.4; P< 0.001), antimicrobial treatment (RR: 5.1; P <0.001), bronchoscopy (RR:
1.5; P¼ 0.041) and tracheostomy (RR: 1.4; P ¼ 0.014). The most frequently isolated causative
pathogens were Pseudomonas aeruginosa and Acinetobacter baumannii. Of all Staphylococcus
aureus isolates, 45.7% were meticillin resistant. Rates, risk factors and causal pathogens of VAP
in ICUs in Hubei differ from those reported from developed countries. These data show the
need for more effective infection control interventions in Hubei, China.
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