Abstract

A STUDY ON VENTILATOR ASSOCIATED PNEUMONIA (VAP) IN THE ADULT INTENSIVE CARE UNIT AT A TERTIARY CARE HOSPITAL

*Aravind Motagi

Abstract

Background: VAP requires a rapid diagnosis and initiation of appropriate antibiotic treatment, as there is adverse effect of inadequate antibiotic treatment on patients’ prognosis and the emergence of multidrug-resistant (MDR) pathogens. Aims &Objectives: To know incidence of VAP infection, the bacterial profile of VAP and the antibiotic resistance pattern from VAP infection. Material & methods: This prospective study was done from 6 bedded adult ICU and included all patients admitted to ICU with devices mechanical ventilator [MV] for>48 h between October 2011 and May 2013. Quantitative culture of endotracheal aspirate was done. Results: Two hundred and eighty four adult patients, on MV for 48 h and more, were included and 64 (22%) developed VAP. Most of the patients had late onset VAP (92%). Non fermenters ,Acinetobacterbaumanniimainly were most common causative agents of early onset & late onset VAP. In late onset VAP, most Acinetobacter baumannii & Pseudomonas aeruginosa were MDRs. Even most of isolates of Enterobacteriaceae family were MDRs. Only one MRSA isolate was seen. Conclusion: Knowledge of the resident microbial flora and their antimicrobial susceptibility pattern with common resistance mechanism is necessary for formulating a rational antibiotic policy in a hospital.

Keywords: VAP, ICU, MDR, MRSA.