Sustained effect of a multifaceted VAP prevention program over more than seven years including the COVID-19 pandemic

Article Article scientifique Article Sustained effect of a multifaceted VAP prevention program over more than seven years including the COVID-19 pandemic eng 2025-11-14 2025-11-14 author Büchler Andrea C. Infection Control Program and WHO Collaborating Center, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland. author Jackson Holly 0000-0003-0646-6437 Infection Control Program and WHO Collaborating Center, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland. 403239 Département de médecine (DEMED) author Buetti Niccolo Infection Control Program and WHO Collaborating Center, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland.,INSERM, IAME, Université Paris-Cité, 75006, Paris, France. 954325 Département de médecine (DEMED) author Boroli Filippo Division of Intensive Care, University Hospitals of Geneva and Faculty of Medicine, University of Geneva, Geneva, Switzerland. 791594 author Juge Christophe Division of Intensive Care, University Hospitals of Geneva and Faculty of Medicine, University of Geneva, Geneva, Switzerland. author Perret Aurélie Division of Intensive Care, University Hospitals of Geneva and Faculty of Medicine, University of Geneva, Geneva, Switzerland. author Koyluk Tomsuk Zilfi Division of Intensive Care, University Hospitals of Geneva and Faculty of Medicine, University of Geneva, Geneva, Switzerland. 990494 author Landelle Caroline Infection Control Unit, Grenoble Alpes University Hospital, Grenoble, France.,University Grenoble Alpes, CNRS, CHU Grenoble Alpes, Grenoble Institute of Engineering (INP), TIMC, Grenoble, France. author Harbarth Stéphan Juergen 0000-0002-3551-1025 Infection Control Program and WHO Collaborating Center, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland. 93885 Département de médecine (DEMED) author Pugin Jérôme Division of Intensive Care, University Hospitals of Geneva and Faculty of Medicine, University of Geneva, Geneva, Switzerland. jerome.pugin@unige.ch.,Hôpital de La Tour, Meyrin, Switzerland. jerome.pugin@unige.ch. 69624 Décanat et administration de la faculté de médecine (ADMED) 139 10.1186/s13756-025-01646-y 41239530 2047-2994 PMC12619505 https://link.springer.com/article/10.1186/s13756-025-01646-y We report the long-term impact of a multifaceted intervention bundle containing nine measures to reduce the incidence of ventilator-associated pneumonia (VAP) in mechanically ventilated patients admitted to the intensive care division at Geneva University Hospitals over a prolonged follow-up period of more than seven years, including the COVID-19 pandemic. The original study included a follow-up of 11 months and showed a marked decrease in VAP incidence. We compared the five pre-defined time periods (pre-intervention, intervention, post-intervention, prolonged follow-up, and COVID-19 pandemic period) using a Poisson model. The incidence of VAP per 1000 ventilator days reduced from 24.3 (95% confidence interval [CI] 18.8-30.9) in the pre-intervention period to 3.9 (95%CI 2.0-6.8) in the post-intervention period. During the prolonged follow-up and the COVID-19 pandemic periods, VAP incidence per 1000 ventilator-days remained similar as in the initial post-intervention period with 4.0 (95%CI 2.9-5.4) and 3.7 (95%CI 2.8-4.7), respectively. Adherence to the bundle measures was assessed using the monthly percentage of correct observations and shown overall for each of the five time periods. Adherence to all but two bundle measures (oral care and hand hygiene) remained high or even improved during the prolonged follow-up period. In conclusion, after implementing a VAP prevention bundle in 2014, there was a sustained effect on VAP incidence during a 7-year follow-up, including the COVID-19 pandemic period. Bundles Implementation Intensive care unit Multimodal strategy Prevention and control Ventilator-associated pneumonia Humans Pneumonia, Ventilator-Associated / prevention & control Pneumonia, Ventilator-Associated / epidemiology COVID-19 / epidemiology COVID-19 / prevention & control Incidence Respiration, Artificial / adverse effects SARS-CoV-2 Intensive Care Units Infection Control / methods Male Female Middle Aged Switzerland / epidemiology Aged Pandemics Dewey 616 Dewey 617 56 Département de médecine 221 63 Département d'anesthésiologie, pharmacologie, soins intensifs et urgences 229 false 526 Résistance aux antibiotiques 866 321 Groupe Pugin Jérôme (Soins intensifs) 587 Antimicrobial resistance and infection control 14 1 ea614284-4b91-49f2-9550-f3c09b880769 Article (Published version) Public Article_scientifique_from_europePmc.pdf 1239254 application/pdf CC BY-NC-ND-4.0 9de6262b11eb5f02ffe9a910c9271c162c785c97bea8de9c96705ee149594ee7 1c8baa5b-c318-4f26-969f-28ac5c420cf0 Appendix Public 13756_2025_1646_MOESM1_ESM.docx 95215 application/vnd.openxmlformats-officedocument.wordprocessingml.document beb0aa5c6d76471a2fb8c645f7a4a5c2dd0cd81c14691e4f21d7c35ff45c08ea openAccess Faculté de médecine / Section de médecine clinique / Département de médecine Faculté de médecine / Section de médecine clinique / Département d'anesthésiologie, pharmacologie, soins intensifs et urgences

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Sustained effect of a multifaceted VAP prevention program over more than seven years including the COVID-19 pandemic	Antimicrobial resistance and infection control			2025	15	73

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