“Ventilator associated pneumonia: Incidence and microbiology in a tertiary care hospital in Maharashtra”

Abstract

Background: Ventilator associated pneumonia (VAP) is common complication in patients receiving mechanical ventilation. The causative organisms of VAP are diverse and many times multidrug resistant. An early, appropriate antibiotic therapy depending on the likely pathogens is a key to VAP management. The present study aims at finding the incidence of VAP and identifying prevalent microbial pathogens associated with VAP in a tertiary care hospital. Methods: Endotracheal aspirates from clinically suspected VAP patients were subjected to microbiological analysis. Isolated pathogens were identified by standard microbiological techniques. Results: A total of 330 patients received mechanical ventilation for more than 48 hours with a total of 1490 ventilator days. 78 (23.63%) patients were clinically suspected to have VAP. The rate of VAP was 52.34 cases per 1000 ventilator days. With microbiological analysis, significant pathogens were isolated from 74 patients, with predominance of Gram negative bacteria. The most prevalent organism isolated was Klebsiella species from 29 patients (39.18%), followed by Pseudomonas aeruginosa, Acinetobacter species, Citrobacter species, Proteus species, E. coli and S. aureus in that order. Conclusion: Knowledge of prevalent organisms causing VAP (e.g. Gram negative organisms in our study) is useful to formulate an effective empirical antibiotic policy, to reduce the morbidity, hospital stay and cost of the treatment of these patients. Keywords: Ventilator associated pneumonia, VAP, Pneumonia, Mechanical ventilation, Endotracheal aspirates