Ventilator-associated pneumonia in intensive care units of a tertiary care hospital in Punjab

Abstract

Introduction

Health care associated infections from invasive medical devices in intensive care pose the highest risk prolonging the hospital stay and cost for the patients. Ventilator-associated pneumonia (VAP) is an important infection in mechanically ventilated patients. Due to increasing incidence of multidrug-resistant organisms in intensive care units (ICUs), early and correct diagnosis of VAP is an urgent challenge for an optimal antibiotic treatment.

Objectives

The aim of this study was to assess the incidence, commonest pathogens, and resistance pattern of isolates of VAP in ICUs of a tertiary care hospital.

Material and methods

A prospective study was performed over a period of six months, enrolling patients undergoing mechanical ventilation for >48 h. Endotracheal aspirates and bronchoalveolar lavage samples were collected from patients suspected of VAP and semi-quantitative cultures were performed on all samples. VAP was diagnosed by m-CPIS score (≥6).

Results

A total of 2369 patients were admitted in ICUs, of which 979 patients were on ventilator assistance (4165 ventilator days). Out of these, 47 (4.8%) patients developed VAP and early onset VAP was seen in 66% cases. The VAP rate was 11.03/1000 ventilator days. The commonest pathogen was Acinetobacter spp. followed by Pseudomonas spp. and Klebsiella spp. Most of the Acinetobacter spp. were resistant to cephalosporins, ciprofloxacin, and showed maximum susceptibility to tigecycline and polymyxin B.

Conclusions

The early onset VAP was more and incidence was high in males. This study highlights the predominance of resistant Gram-negative pathogens in VAP cases.