High Prevalence of Hospital-Acquired Pneumonia Observed in Paraguayan ICU Study

A newly published study from the National Hospital in Paraguay has reported a high prevalence of hospital-acquired pneumonia (HAP) among patients in the intensive care unit (ICU), revealing a significant burden of infection in this critical care setting. The findings, published in The Egyptian Journal of Bronchology, highlight the need for improved prevention strategies and infection control protocols.

The retrospective analysis reviewed medical records from 160 adult ICU patients admitted between January 2022 and March 2023. Of these, 52.5% were diagnosed with HAP—a figure notably higher than those reported in comparable regional studies. Notably, 94% of these infections were linked to mechanical ventilation, classifying them as ventilator-associated pneumonia (VAP).

The study found that patients with chronic conditions such as hypertension (73.8%), chronic kidney disease (66.7%), and heart failure (51.2%) were more likely to develop HAP. The average ICU stay for all patients was 17.7 days, with those affected by HAP experiencing significantly longer hospitalizations. Mortality among patients with HAP was 72.6%, compared to 19.7% in those without the infection.

Acinetobacter baumannii was the most frequently isolated pathogen (57.1%), followed by Klebsiella pneumoniae (23.8%) and Pseudomonas aeruginosa (7.1%). These organisms are known for their resistance to multiple antibiotics, posing treatment challenges and contributing to extended hospital stays.

The study also identified several extrinsic risk factors significantly associated with HAP, including mechanical ventilation, re-intubation, use of nasogastric tubes, and tracheostomy. The presence of a tracheostomy, in particular, was associated with a markedly higher risk of infection.

Compared to earlier studies in the region, the mortality and infection rates reported here are considerably higher. The authors suggest this may be due to a higher proportion of patients requiring mechanical ventilation and the prevalence of multidrug-resistant organisms.

The study underscores the need for rigorous infection prevention measures, including adherence to ventilator care protocols, early identification of at-risk patients, and optimized use of antimicrobial therapies. Given the strong association between HAP and mortality in ICU settings, the authors advocate for enhanced training of healthcare personnel and targeted interventions to reduce infection rates.

This research contributes important local data to the global body of evidence on nosocomial infections and emphasizes the critical role of infection control in improving patient outcomes in intensive care environments.

Source

Karen Melgarejo Marecos, Leticia Escobar Rivela, and Guillermo Insfran Méndez, "Hospital-Acquired Pneumonia in Patients Hospitalized in the Intensive Care Unit of a National Hospital of Paraguay," The Egyptian Journal of Bronchology 19, no. 33 (2025), https://doi.org/10.1186/s43168-025-00389-z.