Nosocomial Pneumonia in Critically Ill  Patients in India–A Clinical Study

Dr. Girish. L. Dandagi; Dr. Isaac Mathew; Dr. G. S. Gaude

Volume : II, Issue : II, February - 2013

Nosocomial Pneumonia in Critically Ill Patients in India–A Clinical Study

Dr. Girish. L. Dandagi, Dr. Isaac Mathew, Dr. G. S. Gaude

Abstract :

Background and aim: Nosocomial pneumonia (NP) and ventilator-associated pneumonia (VAP) remains the commonest cause of morbidity and mortality in spite of latest diagnostic and management modalities. This project aims to study the bacterial pattern and their associated risk indicators in patients admitted to different intensive care units (ICUs) Study design: This Prospective study was done at KLEs, Jawaharlal Nehru Institute of Medical sciences and Research centre, a tertiary care centre with a total bed capacity of 1600 in Belgaum, Karnataka, India. Study included critically ill patients admitted at different ICUs, {MICU (medical ICU) with 45 beds, CICU (Coronary ICU) 25 beds} who developed NP and VAP. Materials and Methods: Total of 100 patients were studied for 10 months between 20-80 yrs. Signs and symptoms, bacterial pattern and risk indicators were noted. Statistical analysis used: Observational study. Results: Among total 100 patients (in different ICUs set ups), 60 patients developed NP but were not mechanically ventilated whereas 40 patients developed VAP after MV for 4-8 days. Majority of the patients were males. Pneumonia developed in patients with diabetes mellitus 21(21%) then least among Ischemic heart diseases (IHDs) and onchial asthma patients 5(5%). The predominantly organisms among NP were Klebsiella pneumonia 7(70%), Streptococcus pneumoniae and Pseudomonas aeruginosa, whereas in VAP were Pseudomonas aeruginosa 6 (37.5%) and Streptococcus pneumoniae. The prognosis with late onset NP was better than VAP. Conclusion: Knowledge about risk indicators may be useful in implementing simple and effective preventive measures in order to minimize the occurrence of Nosocomial infections.