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Revista chilena de infectología

versión impresa ISSN 0716-1018


NAVARRETE C, MARITZA et al. Waste of material employed in mechanical ventilator systems as a risk factor for ventilator-associated pneumonia. Rev. chil. infectol. [online]. 2004, vol.21, n.1, pp.09-16. ISSN 0716-1018.

Ventilator associated pneumonia (NAVM) is one of the most frequent nosocomial infections  (NI) and of more impact in morbidity and mortality in Chile. In spite of the habitual measures of prevention of  NI applied in our hospital during the year 2002, an increase  was observed in the rate of NAVM, next to the isolation of a larger percentage of Acinetobacter baumannii, an endemic strain. In order to identify possible niches of NI microorganisms,  a study was planned which involved the patient (tracheal secretion) and the ventilation systems; humidifier, endotracheal  tube, Y tube, and ventilator-tubing. The ventilator tubing was studied by sweeping microscopy to specify characteristics of the material. After seven days, time of replacement settled down by the National Committee of NI, colonization was observed for A. baumannii, Pseudomonas aeruginosa and Klebsiella pneumoniae, agents associated to NI in two patients. In pre-sterilization like in post-sterilization the circuit of mechanic ventilation  belonging to a patient  with nosocomial pneumonia was studied and in both cultures, multi-resistant microorganisms were isolated. When analyzing by sweeping microscopy portions of the circuit, a wearing of the tubing was observed with multiple cracks with coccoidal  and bacilar forms included in the structure. When studying different circuits, both pre and post-sterilization, in two of them positive cultures were obtained after the sterilization in  ethylene oxide. Our data emphasizes the necessity of incorporating routinely in the guidelines of infection control, those related to reusable material.

Palabras clave : Ventilator associated pneumonia; Ventilator circuits; Reutilization.

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