The value of modified clinical pulmonary infection score as an early predictor of ventilator associated pneumonia in the ventilated neonates / Dina Khedr Sayed Mohamed ; Supervised Mohamed Elsayed Hashim , Abdelrahman Ahmed Abdelrazek , Sherif Elanwary Abdelmoneim

Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Pediatrics

Background: ventilator-associated pneumonia (VAP) is one of the commonest nosocomial infections occurring in mechanically ventilated patients in the intensive care unit (ICU). Since the diagnosis of VAP is very difficult, a lot of researches were done trying to find an easy way to confirm the diagnosis, one of these methods is the modified clinical pulmonary infection score3 mCPIS. Aim: although the modified clinical pulmonary infection score has been approved by many organizations, only few studies have been done about its value as an early predictor of ventilator-associated pneumonia (VAP) in the ventilated neonates. methods: In our study Thirty three neonates were prospectively included and the mCPIS was calculated on day 2 and day 5 post mechanical ventilation and correlated to the tracheal aspirate (microbiological criteria for diagnosis of VAP) done on the same retrospective days. Results:the data showed that a mCPIS of 6 or higher had a sensitivity of 89.7%%, specificity of 70.5%, positive predictive value of 70.5%%, negative predictive value of 89.7% and accuracy of 84.8%. Also there was Relation between scoring and tracheal aspirate with a significant p value of < 0.05 and a significant relation between score and outcome with a significant p value of < 0.05. Conclusion: the mCPIS has a reasonable performance and it could be used as an early predictor of VAP even if the culture is pending as a score of 6 or higher is usually associated with VAP and a score with less than 6 is usually not associated with VAP

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