Prevalence of ventilator-associated pneumonia and bacterial isolates in mechanically ventilated dogs

TL;DR

This study examines how often ventilator-associated pneumonia occurs in dogs on mechanical ventilation and identifies common bacteria involved.

Contribution

The study evaluates the prevalence of ventilator-associated pneumonia in dogs using CDC guidelines and clinician suspicion.

Findings

None of the dogs met CDC or modified veterinary guidelines for ventilator-associated pneumonia.

Twelve cases were suspected of VAP based on clinician judgment.

Pseudomonas aeruginosa was the most common isolate, with some resistant to fluoroquinolones.

Abstract

Mechanical ventilation is used to treat respiratory failure in veterinary patients. Ventilator-associated pneumonia (VAP) is a reported complication of mechanical ventilation in both human and veterinary medicine. VAP can lead to increased length of mechanical ventilation, longer hospital stays, and increased mortality. While there are no gold-standard diagnostic criteria, the CDC has proposed surveillance guidelines for human medicine. A modified version of these guidelines has been created for veterinary medicine. The goal of our study was to determine the prevalence of VAP according to the CDC VAP surveillance guidelines, the modified veterinary guidelines, and clinician suspicion.

The medical records at an academic institution were searched for patients mechanically ventilated over 24 h.

None of these patients met the CDC VAP surveillance guidelines or the modified guidelines for veterinary medicine. Twelve of 71 cases were concerning for possible VAP based on clinician suspicion. The most common organism grown in both the group with clinician suspected VAP and the group without was Pseudomonas aeruginosa, eight of which were resistant to fluoroquinolones.

It is likely that VAP is either over or under diagnosed in this population, as the clinician suspected VAP is based on subjective criteria. Findings suggest that avoiding fluoroquinolones may be beneficial when selecting an empiric antibiotic for cases in which VAP is suspected. Future studies should assess adaptions to the modified VAP surveillance guidelines for veterinary medicine because having guidelines that are too strict could eliminate cases altogether.

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