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title:Ventilator-Associated Pneumonia in a Tertiary Care Intensive Care Unit: Analysis of Incidence, Micro-Biological Profile, Resistant Pattern and Outcome

Author:Sandeep Kumar, Malay Sarkar, D V Singh, R S Negi, Sunil Sharma, Sanjeev Prabhakar

Keywords:ventilator associated pneumonia,Acinetobacter baumannii, colistin

Type:Original Article

Abstract:"Background: Ventilator-associated pneumonia (VAP) is the most common nosocomial infection diagnosed in the intensive care unit (ICU). Aims: The aim is to determine the incidence, bacteriology and resistant pattern and 28 days mortality in intensive care unit. Methods: This prospective study was conducted in intensive care unitfrom July 2017 through June 2018. All the patients who were on mechanical ventilation for >48 h in the ICU during the study period were enrolled. VAP was diagnosed according to the Centre for Disease Control (CDC) criteria. Fisher's exact test was applied to compare two or more set of variables.P-value less than 0.05 was considered to be statistically significant. Results: A total of 117 patients were included in the study and VAP developed in 49 patients with an incidence of VAP 0.42% episodes of infection/1000 mechanical ventilation days(95% Confidence Interval: 0.32 to 0.514).These were predominantly caused by Gram-negative organisms and the most common organism isolated was Acinetobacter baumanii(12 isolates,40%). Acinetobacter baumanii infection was associated with prolonged ICU stay(P value 0.009).Colistin was the most effective drug in our study and found to be effective in >90% of the patients. The overall mortality of VAP patients in our study was 36.7%. Patients with underlying diabetes mellitus and hypertension had adverse outcome in comparison to the patients without underlying comorbidity (P value=0.017). Conclusions: VAP continues to be a major threat to patients who are admitted for mechanical ventilation into the critical care unit, emphasizing the urgent need for infection control measures.

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