PD307 - HOSPITAL-ACQUIRED PNEUMONIA VERSUS OTHER HOSPITAL-ACQUIRED INFECTIONS DURING IMPLEMENTATION OF NUTRITIONAL GUIDELINES IN CRITICALLY ILL PATIENTS

PD307

HOSPITAL-ACQUIRED PNEUMONIA VERSUS OTHER HOSPITAL-ACQUIRED INFECTIONS DURING IMPLEMENTATION OF NUTRITIONAL GUIDELINES IN CRITICALLY ILL PATIENTS

R. H. M. Zaki^1,*

¹critical care medicine, faculty of medicine, alexandria university, alexandria, Egypt

Rationale: To evaluate the effect of protocol-based nutritional management on the incidence of HAP compared with other hospital-aquired infections in critically ill patients.

Methods: In this prospective interventional study, 316 adult ICU patients were enrolled and divided into two groups: standard nutritional care (Group 1, n=162) and protocol-driven nutritional management based on ESPEN recommendations and mNUTRIC risk stratification (Group 2, n=154). All HAIs occuring ≥48 hours after ICU admission were recorded, including pneumonia, urinary tract infections (UTI), blood stream infections (BSI), and wound infections. The primary outcome was the relative rate of HAP compared with other HAIs. Survival was assessed at 30 and 90 days.

Results: Overall HAI incidence was high but lower in the nutrition-guided group (85.2% in Group 1 vs 77.3% in Group 2). HAP was the most frequent infection in both groups but occurred significantly less often with protocol-based nutritional therapy (63.0% vs 54.5%). UTIs were also reduced (70.4% vs 54.5%). In contrast, BSIs and wound infections were more frequently detected in the intervention group (36.4% vs 14.8%), likely reflecting longer survival and prolonged ICU exposure. Kaplan-Meier analysis demonstrated that pneumonia was independently associated with worse 30-day and 90-day survival.

Conclusion: Implementation of structured nutritional guidlines significantly reduced the burden of hospital-aquired pneumonia and overall HAIs in critically ill patients. Despite optimized nutrition, HAP remains the dominant infectious complication and key driver of mortality. These findings support early nutritional risk stratification and protocol-based nutrition as essential components on ICU infection prevention strategies.

Disclosure of Interest: None declared