Epidemiology and disease burden among hospital-acquired pneumonia/ventilator-associated pneumonia patients in a tertiary care hospital

Background: Hospital-acquired pneumonia (HAP) are one of the major healthcare-associated infection but its burden and financial impact are lesser studied comparing to ventilator-associated pneumonia (VAP). The study aims to investigate the disease burden, etiology and the outcome among HAP/VAP patients in Taiwan. Methods This is a retrospective study conducted in a teaching hospital in Taiwan. We enrolled patients with HAP/VAP during 1st Jan. 2018 to 31st Dec. 2018. The definition of HAP/VAP was based on definition proposed by the Taiwan Centers of Disease Control and the hospital-wide data was audited prospectively by Center for Infection Control of the hospital. Patients with HAP were further categorized as non-ventilated HAP (nvHAP) and ventilated HAP (vHAP). The burden of HAP/VAP was estimated and the clinical outcomes were compared between nvHAP and vHAP. Results In total, 152 episodes of HAP and 8 episodes of VAP were identified. The incidence of HAP was 0.22 (95% confidence interval [CI], 0.19–0.26) per 1,000 patients-days while that of VAP was 0.27 (95% CI, 0.12–0.53) per 1,000 ventilator-days. The mortality was similar between vHAP and nvHAP in our cohort (55.6% vs. 62.6%, respectively, p = 0.58). However, vHAP was associated with higher length of hospital stay (56 vs. 37 days, p < 0.001) and medical expenses (787,621 vs. 455,347 New Taiwan Dollar, p < 0.001). Conclusions The study provides the infection incidence density of HAP and VAP in a tertiary care hospital. Due to the disease burden and the medical cost, prevention and treatment of HAP and VAP are an important element of infection control.