Table 2.
Reported VAP rates and ventilator utilization ratios—all ICU types
| Source | City/country | ICU type | Year(s) | VAP definition used | VAP ratea | Ventilator utilization ratiob |
|---|---|---|---|---|---|---|
| Al-Dorzi et al., 2012 [14] | Riyadh, Saudi Arabia | Adult medical, surgical, trauma | 2003 | US CDC criteria | 19.1 | 0.7 |
| 2009 | 6.3 | 0.5 | ||||
| 2003–2009 | 15.9 | 0.6 | ||||
| Bukhari et al., 2012 [19] | Makkah, Saudi Arabia | Adult medical, surgical | 2009 | Pneumonia in a patient intubated and ventilated at the time of, or ≤ 48 h before the onset of the event | 3.4 | NR |
| 2010 | 2.0 | NR | ||||
| Al-Tawfiq et al., 2013 [17] | Dhahran, Saudi Arabia | Adult medical, surgical, cardiac | 2004 | MV with chest X-ray showing new or progressive infiltrate, consolidation, cavitation, or pleural effusion | 9.8 | NR |
| 2011 | 1.3 | NR | ||||
| 2004–2011 | 4.5 | NR | ||||
| Adult medical | 2004–2011 | 5.0 (0.4–9.4) | 0.7 (0.6–0.7) | |||
| Adult surgical | 2004–2011 | 4.9 (2.1–8.4) | 0.6 (0.5–0.7) | |||
| Adult cardiac | 2004–2011 | 1.9 (0–3.7) | 0.2 (0.2–0.3) | |||
| Al-Thaqafy et al., 2014 [18] | Riyadh, Saudi Arabia | Adult medical, surgical, trauma | 2010 | US CDC/NHSN criteria | 3.6 | 0.7 |
| 2013 | 1.0 | 0.6 | ||||
| Shaath et al., 2014 [52] | Riyadh, Saudi Arabia | Pediatric cardiac (postcardiac surgery patients) | 2010 | US CDC criteria | 29.0 | 0.3 |
| Ali et al., 2016 [23] | Doha, Qatar | Adult medical, surgical, trauma | 2010 | US CDC criteria | 5.4 | NR |
| 2011 | 5.9 | NR | ||||
| 2012 | 3.9 | NR | ||||
| Adult medical | 2010 | 3.9 | NR | |||
| 2011 | 4.0 | NR | ||||
| 2012 | 2.3 | NR | ||||
| Adult surgical | 2010 | 3.1 | NR | |||
| 2011 | 5.7 | NR | ||||
| 2012 | 5.1 | NR | ||||
| Adult trauma | 2010 | 10.1 | NR | |||
| 2011 | 8.7 | NR | ||||
| 2012 | 5.8 | NR | ||||
| Al-Mousa et al., 2016 [34] | Kuwait City, Kuwait | Adult medical, surgical | Nov 2013–Mar 2015 | US CDC/NHSN criteria | 4.0 (2.9–5.3) | 0.9 (0.9–0.9) |
| Adult coronary | Nov 2013–Mar 2015 | 12.9 | 0.1 (0.1–0.1) | |||
| Pediatric | Nov 2013–Mar 2015 | 0.3 (0.2–4.6) | 0.7 (0.7–0.7) | |||
| Neonatal | Nov 2013–Mar 2015 | 1.0 | 0.5 (0.4–0.5) | |||
| El-Saed et al., 2016 [9] | Bahrain, Oman, and Saudi Arabia | Medical/surgical, neurosurgical, surgical, trauma, pediatric, pediatric cardiothoracic, and neonatal | 2008–2013 | NHSN criteria | 4.8 (4.3–5.3) | 0.6 (0.6–0.6) |
| 2008 | 7.4 (5.5–9.2) | 0.5 (0.5–0.5) | ||||
| 2009 | 6.6 (5.1–8.1) | 0.6 (0.6–0.6) | ||||
| 2010 | 4.7 (3.7–5.7) | 0.6 (0.6–0.6) | ||||
| 2011 | 5.4 (4.3–6.5) | 0.6 (0.6–0.6) | ||||
| 2012 | 3.0 (2.1–3.8) | 0.6 (0.6–0.6) | ||||
| 2013 | 2.0 (0.9–3.0) | 0.5 (0.5–0.5) | ||||
| Medical/surgical | 2008–2013 | 5.4 (4.8–6.0) | 0.6 (0.6–0.6) | |||
| Pediatric | 2008–2013 | 2.4 (0.8–3.9) | 0.5 (0.5–0.5) | |||
| Neonatal | 2008–2013 | 1.8 (0.9–2.8) | 0.3 (0.3–0.3) | |||
| Trauma | 2010–2013 | 1.3 (0.0–3.9) | 0.6 (0.6–0.6) | |||
| Neurosurgical | 2010 | 4.3 (0.1–8.5) | 0.6 (0.6–0.6) | |||
| Pediatric cardiothoracic | 2010 | 3.5 (0.1–7.0) | 0.6 (0.6–0.6) | |||
| Surgical | 2013 | 1.6 (0.0–4.8) | 0.5 (0.4–0.5) | |||
| Banjar et al., 2017 [20] | Makkah region, Saudi Arabia | Adult, surgical, coronary care, pediatric, and neonatal | 2013 | NR | 6.9c (IQR, 3.6–10.3) | NR |
| Makkah, Makkah, Saudi Arabia | Not specified | 2013 | 6.4c (IQR, 3.2–8.2) | NR | ||
| Jeddah, Makkah, Saudi Arabia | Not specified | 2013 | 8.8c (IQR, 4.6–20.2) | NR | ||
| Taif, Makkah, Saudi Arabia | Not specified | 2013 | 6.1c (IQR, 3.6–11.6) | NR | ||
| Qunfudah, Makkah, Saudi Arabia | Not specified | 2013 | 4.4c (IQR, 0.6–6.3) | NR | ||
| Al-Mousa et al., 2018 [16] | Kuwait City, Kuwait | Adult medical/surgical, coronary | Jan–Mar 2014 | US CDC/NHSN criteria | 7.0 (3.8–11.8) | 0.7 |
| Apr 2014–Mar 2015 | 3.6 (2.5–5.0) | 0.8 | ||||
| Gaid et al., 2018 [56] | Provinces of Asser, Jeddah, Riyadh, and Qassim, Saudi Arabia | Adult medical/surgical | May 2015–Feb 2016 | NR | 18.1–26.6 | 0.5 (0.5–0.6) |
| Provinces of Asser and Taif, Saudi Arabia | Adult medical/surgical | Sep 2013–Mar 2015 | 9.3–20.7 | 0.3 (0.3–0.3) | ||
| Provinces of Najran and Tabuk, Saudi Arabia | Adult medical/surgical | Sep 2013–Feb 2016 | 0.9–16.4 | 0.7 (0.6–0.7) | ||
| Provinces of Taif, Hail, and Madina, Saudi Arabia | Adult medical/surgical | Sep 2015–Mar 2016 | 10.1–51.6 | 0.9 (0.9–1.0) | ||
| Province of Riyadh, Saudi Arabia | Adult medical/surgical | Jan 2015–Feb 2016 | 186.5 | 0.1 (0.04–0.1) | ||
| Abulhasan et al., 2020 [32] | Kuwait | Neurocritical care (97% adult patients) | 2015 | US CDC/NHSN criteria | 11.1 | 0.4 |
| 2016 | 5.7 | 0.2 | ||||
| 2017 | 6.1 | 0.4 | ||||
| Ahmed et al., 2021 [57] | Riyadh, Saudi Arabia | Not specified (60-bed hospital) | 2019 | US CDC criteria | 2.1 | NR |
| Alfouzan et al., 2021 [29] | Kuwait | Adult medical/surgical | 2018, 2019 | Pneumonia in a patient on MV for > 2 days on the date of event | 4.2 | 0.7 |
CI confidence interval, ICU intensive care unit, IQR interquartile range, MV mechanical ventilation, NHSN National Healthcare Safety Network, NR not reported, US CDC US Centers of Disease Control and Prevention, VAP ventilator-associated pneumonia
aPer 1000 ventilator-days (where provided, error is 95% CI, unless otherwise indicated)
bVentilator utilization ratio is the number of ventilator days/number of patient days (where provided, error is 95% CI)
cMedian value