Historical cohort (n = 53) including all burn patients with inhalation injury requiring mechanical ventilation, admitted to the Ghent burn unit (2002-2010).
Median (interquartile range) age and total burned surface area were 44y (39-55y) and 35%(19-50%). Overall, 70 episodes of VAP occurred in 46 patients (86.8%). Median mechanical ventilation days (MVD) prior to VAP onset were 7d (4-9d). The incidence was 55 episodes/1000 MVD. In 23 episodes (32.9%) at least one MDR causative pathogen was involved, mostly Pseudomonas aeruginosa and Enterobacter spp. The sensitivity and specificity of surveillance cultures to predict MDR etiology in subsequent VAP was respectively 83.0%and 96.2%. The positive and negative predictive value was 87.0%and 95.0%, respectively.
The incidence of VAP in burn patients with inhalation injury is high. In this cohort routine surveillance cultures had excellent operating characteristics to predict MDR pathogen involvement.