Frequency and Etiology of Ventilator-Associated Pneumonia in COVID-19 Patients Presenting to Tertiary Care Hospital

Abstract

Objective: To establish the frequency and aetiology of the pathogens causing Ventilator-Associated Pneumonia in COVIDpatients admitted to a tertiary care hospital. Study Design: Cross-sectional study. Place and Duration of Study: Department of Medicine and Intensive Care, Pak Emirates Military Hospital, RawalpindiPakistan, from July 2021 to Feb 2022. Methodology: Patients between 25 to 70 years of age of either gender with severe COVID pneumonia with positive RT-PCR, clinical and radiological evidence of critical disease, and needing ventilatory support due to respiratory failure were included in this study. Ventilator-associated pneumonia (VAP) was identified and confirmed by positive culture taken 48 hours after intubation, and Cultures noted organisms. Results: Of 300, 238(79.3%) patients developed Ventilator-Associated Pneumonia (VAP) 48 hours after intubation. VAP was diagnosed by positive cultures taken from bronchial secretions and blood samples. Culture report analyses were assessed for pathogens, which revealed Klebsiella pneumonia (KP) being the most common pathogen 64(26.9%), followed by Acinetobacter baumannii 49(20.6%) and Pseudomonas aeruginosa 26(10.9%). Polymicrobial culture results were also seen,which revealed Acinetobacter+Klebsiella in 29(12.2%) subjects, Pseudomonas with KP in 33(13.9%), and Acinetobacter with Pseudomonas aeruginosa in 13(5.5%). Conclusion: Klebsiella pneumonia is the most common pathogen found to cause VAP in COVID-19 patients. Around 30% of polymicrobial cultures were noted.