Authors : Chandan Kumar Shit, Sudarsan Pothal, Pravati Dutta, Rekha Manjhi, Aurobindo Behera
DOI : 10.18231/j.ijirm.2019.037
Volume : 4
Issue : 3
Year : 2019
Page No : 164-169
Background: For treatment of Ventilator-associated pneumonia (VAP) the prevalent causative agent needs to be known at individual Intensive Care Unit (ICU) for choosing empirical antibiotics. We aimed to determine the prevalence of VAP, rate of VAP, prevalence of microbiological agent along with drug sensitivity and the factor associated with survival of ventilated patient.
Methodology: This study included 65 patients on mechanical ventilation for more than 24 hours at medical college ICU. VAP was diagnosed based on Modified Clinical Pulmonary Infection Score (CPIS) > 6 and having a positive quantitative culture of the endotracheal aspirate with the presence of radiological infiltrates in chest X-ray.
Results: VAP developed in 41.5% of patients & 12.35 cases /1000 ventilator days. 37% were caused by Klebsiella pneumoniae, 26% by Acinetobacter baumanii & 15% by Pseudomonas aeruginosa. 96% of patients were harbouring extended spectrum beta-lactamases (ESBL) producing isolates, 78% multi drug resistant(MDR), 18% carbapenem resistant. Factors like age, gender, type of patient (medical/surgical), number of ventilator days were not associated with the occurrence of VAP. Advanced age, number of days in mechanical ventilator, presence of radiological finding & resistant organism were risk factors associated with the non-survival of non-VAP patients. Younger age, male gender & early onset VAP were associated with survival in a VAP group of patients.
Conclusions: In our ICU the rate of VAP is very high along with the high prevalence of MDR organism also. But occurrence of VAP was not associated with a length of mechanical ventilation. VAP not even associated with high mortality rate.