Ventilator associated pneumonia (VAP) in an intensive care unit of a tertiary care hospital: incidence, their microbial etiology, risk factors and role of multidrug resistant pathogens

Prashant V. Male; Manish kumar Kashyap; Riddhi Ajay Bora; Vinayak V. Kshirsagar

Volume : VII, Issue : II, February - 2017

Ventilator associated pneumonia (VAP) in an intensive care unit of a tertiary care hospital: incidence, their microbial etiology, risk factors and role of multidrug resistant pathogens

Prashant V. Male, Manish Kumar Kashyap, Riddhi Ajay Bora, Vinayak V. Kshirsagar

Abstract :

Background VAP is serious nosocomial infection and is associated with multi–drug resistant organisms studied. The aim of study is to find the incidence, microbial causes, antibiotic susceptibility pattern and the incidence of multidrug resistant organisms associated of VAP in mechanically ventilated patients in intensive care units of a tertiary care hospital. Patients and Methods: In this study, a prospective study of 50 patients with VAP between January 2016 and December 2016 was performed based on age, gender, underlying illness, duration of hospitalization and mechanical ventilation, prior antibiotic treatment were obtained . Result: 6 (12%) were diagnosed to have VAP of which, 2(33.3%) patients developed early onset and 4(66.6%) have late onset VAP. VAP was polymicrobial in 2 (33.3%) patients and monobacterial in 4(66.6%) cases. , Klebsiella pneumoniae was the most common organism associated with VAP. Out of 7 gram negative organisms, 6(85.7%) were multidrug resistant and ESBL producers. Mortality rate in VAP patients 50% and in neonates 100%. Risk factor found in VAP cases were increased duration mechanical ventilation, prior antibiotic therapy in adults and in neonates was low birth weight. Conclusions: VAP is increasingly found to be associated with multi–drug resistant organisms that explain the high rate of colonization due to these pathogens. Etiological agents also vary based on type of ICU and patient studied. Therefore knowing the susceptibility pattern of local microbial isolates guide the clinician to choose the appropriate empirical therapy followed by de–escalation strategy focused on narrow spectrum antibiotics after the culture and sensitivity report.