Abstract
: Like any other Device associated infection, Ventilator Associated Pneumonia also poses a great threat to public health. This study aims to know the prevalence rate of VAP and study the drug resistance pattern of its causative agents. : A prospective, observational study involving 480 patients was conducted over a period of twelve months to calculate the prevalance of VAP amongst the intubated patients and to isolate the causative organisms with their resistance patterns for antibiotics. : Among the 480 patients on mechanical ventilation included in this study, sixty patients developed VAP. This amounted to a VAP rate of 31.25 per 1000 ventilator days. Culture yielded Gram negative organisms in 51 samples and Gram positive cocci in 9, majority of which were multi drug resistant organism by the virtue of producing ESBL, AmpC and MBL enzymes. : Identifying VAP and the MDR organisms causing it and formulating a tailored antibiotic therapy is very imperative for the timely treatment and reduction in morbidity and mortality caused by VAP.
Highlights
Like any other Device associated infection, Ventilator Associated Pneumonia poses a great threat to public health
Around 8 to 20% of patients admitted in ICU are estimated to be affected by Ventilator associated pneumonia (VAP) and this number goes upto 27% in patients who are on mechanical ventilation
Many previous noted studies have documented the risk factors for acquiring VAP. These risk factors include male sex, preexisting pulmonary disease, multiple organ system failure, the presence of intubation or enteral feeding, mechanical ventilation, and supine position, previous use of antibiotics for more than 2 weeks, diabetes etc. 12,13 Though our study did not mainly focus on the risk factors associated with VAP, 61.66% of patients who developed VAP were males and 20% reported of diabetes as associated co morbidity, conforming with the other studies
Summary
Like any other Device associated infection, Ventilator Associated Pneumonia poses a great threat to public health. Results: Among the 480 patients on mechanical ventilation included in this study, sixty patients developed VAP. This amounted to a VAP rate of 31.25 per 1000 ventilator days. Onset VAP which occurs during first four days of mechanical ventilation is usually less severe, associated with a better prognosis, and is more likely caused by antibiotic sensitive bacteria. Late onset VAP which develops five or more days after initiation of mechanical ventilation is caused by multidrug resistant pathogens and is associated with increased morbidity and mortality. 4 Typically, bacteria causing early-onset VAP include Streptococcus pneumoniae (as well as other streptococcus species), Hemophilus influenza, methicillin-sensitive Staphylococcus aureus (MSSA), enteric Gram-negative bacilli, Escherichia coli, Klebsiella pneumonia, Enterobacter species, Proteus species and Serratia marcescens.
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