Role of endotracheal tube culture or aspirate culture in identifying mechanically ventilated patients at risk for ventilator-associated pneumonia in neonatal intensive care unit at a tertiary care centre

Abstract

Background: Ventilator-associated pneumonia (VAP) is the second most common hospital-acquired infection in Neonatal intensive care units (NICU). The standard methods of diagnosis are not popular because of their invasive nature and cost. Endotracheal aspirate (ETA) is a relatively easy and non-invasive method. The aim of the study was to document the role of routine endotracheal aspirate culture performed in predicting causative organism and selecting effective antibiotic therapy in the event of subsequent ventilator-associated pneumonia.Methods: This study was conducted in the NICU of a medical college over ten months (September 2019 to June 2020). Newborns up to 28 days of life admitted in NICU and mechanically ventilated for more than 48 hours were enrolled in this prospective observational study (cross-sectional study). After 48 hours of ventilation, ET aspirate is collected and sent for culture and sensitivity testing in the microbiology lab. A Chi-square test was applied. P value<0.05 was considered statistically significant.Results: A total of 50 patients were included in this study, of which 15 patients developed VAP. Among the 6 VAP pathogens in this study, 94.12% were gram negative bacilli and 5.88% were gram positive cocci. Acinetobacter baumanii (52.80%) was the most predominating causative organism, followed by Klebsiella, Pseudomonas and E. coli (11.76%), followed by coagulase-negative staphylococcus and Enterobacter cloacae (5.88%).Conclusions: Acinetobacter baumanii was the most common organism isolated. Endotracheal tube aspirate cultures help in the early identification of patients at risk for developing VAP.