Microbiological profile of ventilator associated pneumonia at icu of rural based teaching hospital

Authors: Ankita Patel*, Sucheta Lakhania, Radhika Kharab
Int J Biol Med Res. 2014; 5(2): 4057-4061  |  PDF File

Abstract

BACKGROUND AND OBJECTIVES Ventilator-associated pneumonia (VAP) is an important intensive care unit (ICU) infection in mechanically ventilated patients. VAP occurs approximately in 9-27% of all intubated patients. Due to the increasing incidence of multidrug resistant organisms (MDR) in the ICU, early and correct diagnosis of VAP is an urgent challenge for optimal antibiotic treatment. The aim of the study was to assess the bacteriological and clinical profile of VAP, risk factors, etiology and prevalence of MDR in clinically suspected VAP cases in the ICU setting. METHODS This prospective study was conducted in the period from September 2012 to August 2013, at Department of Microbiology, SBKS MI & RC Piparia, enrolling patients undergoing mechanical ventilation (MV) for >48 h. admitted at in ICU of Dhiraj Hospital Endotracheal aspirates (ETA) were collected from patients with suspected VAP, and quantitative cultures were performed on all samples. VAP was diagnosed by the growth of pathogenic organism ≥105 cfu/ml. RESULTS Out of 50 patients, 28 (56%) had bacteriologically proven VAP. Out of 50 patients 23(46%) had early-onset (<96 hours MV) VAP and 27 (54%) had late-onset (>96 hours MV) VAP. Multi drug-resistant bacteria, mainly Klebsiella pneumoniae (20%), Acinetobacter spps. (16%) and Pseudomonas spps. (14%) were the most commonly isolated pathogens in both types of VAP. ESBL was produced by 67% and 20% of Klebsiella pneumoniae and Escherichia coli respectively. Metallo-beta lactamases (MBLs) were produced by 29% of Pseudomonas spp. INTERPRETATION AND CONCLUSION High prevalence (56%) of VAP and the potential multidrug-resistant organisms are the real threat in our ICU. Combined approaches of rotational antibiotic therapy and education programs might be beneficial to fight against these MDR pathogens and will also help to decrease the incidence of VAP.