Ventilator associated pneumonia in intensive care units of a tertiary care centre of Gujarat

Abstract

Purpose: Healthcare associated pneumonia were reported to be the second most common healthcare associated infection in US intensive care units (ICUs). The mortality attributable to VAP was reported to range between 0 and 50%. Aims: This study was conducted to determine ventilator associated pneumonia (VAP) rate from tracheal aspirates to improve the specificity of the diagnosis of VAP, to restrict antibiotic overuse and its associated problems in patients of Medical and Surgical intensive care units (ICUs). Methods and Material: Study included 233 patients in the MICU or SICU subjected to mechanical ventilation for more than 48 hours. VAP was identified as per the definition of Centres for Disease Control and Prevention. Laboratory confirmation was done by quantitative culture of tracheal aspirates. Results: In MICU, a total of 11 Similarly in SICU, a total of 20 positive samples were diagnosed of having ventilator associated pneumonia VAP rate per 1000 ventilator-days was higher in SICU (19.6) as compared to MICU (10.7). Overall ventilator utilization ratio during the study period for MICU was 0.65 and that for SICU was 0.53. Conclusion: VAP rate in SICU was high compared to MICU in spite of a lower ventilator utilization ratio. Various risk factors contributing to higher VAP rates in SICU must be identified to implement specific preventive measures in SICU. Keywords: Ventilator associated pneumonia, Medical intensive care unit, Surgical intensive care unit, Quantitative culture of tracheal aspirats, Mechanical ventilation