Incidence, Risk Factors, Microbiology and Outcomes of VAP at an NCU in India: A Prospective Observational Study.

IF 1.5 Q3 CRITICAL CARE MEDICINE

Indian Journal of Critical Care Medicine Pub Date : 2025-04-01 DOI:10.5005/jp-journals-10071-24948

Kapil Zirpe, Upendra Kapse, Akansha Sharma, Atul P Kulkarni, Sushma Gurav, Anand Tiwari, Chaitanya Bhujbal, Abhijeet Deshmukh, Prasad Suryawanshi, Prajakta Pote, Abhaya Bhoyar, Kaustubh Zirpe, Rupali Suryawanshi, Rahul Sharma, Piyush Dhawad, Hrishikesh Vaidya

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引用次数: 0

Abstract

Background: Ventilator-associated pneumonia (VAP) remains a major challenge while managing ventilated critically ill patients in neurocritical care units (NCUs).

Materials and methods: This was a prospective, single-center, observational study. All adult patients admitted to our NCU requiring mechanical ventilation (MV) for >48 hours were screened for VAP as per clinical pulmonary infectious score (CPIS) criteria. The primary outcome was the incidence of VAP in the ICU. Secondary outcomes were risk factors, microbiology, percentage of MDR/XDR organisms, mortality, and length of stay (LOS) of VAP.

Results: A total of 24.94% (114 of 457) patients developed VAP. The incidence of VAP was 39.43/1000 ventilator days. Multivariate analysis of the risk factors identified, male gender, low Glasgow coma scale (GCS) of 3-8, prolonged ventilation, and diabetes mellitus as significant risk factors for the development of VAP (p < 0.05). Acinetobacter baumannii (31.58%), Klebsiella pneumoniae (28.95%), and Pseudomonas aeruginosa (13.16%) were the most common organisms responsible for VAP. Most of these isolates were multidrug resistant (MDR) (81.58%), and extensively drug-resistant (XDR) organisms (12.28%). Although VAP patients had longer ICU-LOS (26.2 ± 24.2 vs 11.8 ± 6.9 days, p < 0.0001), it did not affect the mortality (18.4% for VAP vs 14.3% for non-VAP, p = 0.5).

Conclusion: Ventilator-associated pneumonia has a high incidence of 39.43 per 1,000 ventilator days in the Indian neurocritical care setting.

How to cite this article: Zirpe K, Kapse U, Sharma A, Kulkarni AP, Gurav S, Tiwari A, et al. Incidence, Risk Factors, Microbiology and Outcomes of VAP at an NCU in India: A Prospective Observational Study. Indian J Crit Care Med 2025;29(4):308-313.

查看原文本刊更多论文

印度NCU的VAP发病率、危险因素、微生物学和结果：一项前瞻性观察研究。

背景：呼吸机相关性肺炎（VAP）仍然是神经重症监护病房（ncu）管理通气危重患者的主要挑战。材料和方法：这是一项前瞻性、单中心、观察性研究。根据临床肺感染评分（CPIS）标准，对所有入住NCU需要机械通气（MV） bbbb48小时的成年患者进行VAP筛查。主要观察指标为ICU中VAP的发生率。次要结局是危险因素、微生物学、MDR/XDR微生物的百分比、死亡率和VAP的住院时间（LOS）。结果：457例患者中有114例（24.94%）发生VAP。VAP的发生率为39.43/1000呼吸机d。多因素分析发现，男性、低格拉斯哥昏迷评分（GCS） 3-8分、延长通气时间、糖尿病是VAP发生的重要危险因素（p < 0.05）。鲍曼不动杆菌（31.58%）、肺炎克雷伯菌（28.95%）和铜绿假单胞菌（13.16%）是导致VAP的最常见微生物。这些分离株大部分为多重耐药（MDR）（81.58%）和广泛耐药（XDR）（12.28%）。虽然VAP患者的ICU-LOS时间较长（26.2±24.2 vs 11.8±6.9天，p < 0.0001），但不影响死亡率（VAP组18.4% vs非VAP组14.3%,p = 0.5）。结论：在印度神经危重症护理环境中，呼吸机相关肺炎的发病率高达每1000个呼吸机日39.43例。本文引用方式：Zirpe K， Kapse U, Sharma A, Kulkarni AP, Gurav S， Tiwari A等。印度NCU的VAP发病率、危险因素、微生物学和结果：一项前瞻性观察研究。中华检验医学杂志，2015;29(4):308-313。

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来源期刊

Indian Journal of Critical Care Medicine CRITICAL CARE MEDICINE-

CiteScore

3.50

自引率

10.00%

发文量

299

期刊介绍： Indian Journal of Critical Care Medicine (ISSN 0972-5229) is specialty periodical published under the auspices of Indian Society of Critical Care Medicine. Journal encourages research, education and dissemination of knowledge in the fields of critical and emergency medicine.