Epidemiological and microbiological analysis of ventilator-associated pneumonia patients in a public teaching hospital (original) (raw)
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BACTERIOLOGICAL STUDY OF VENTILATOR-ASSOCIATED PNEUMONIA IN A TERTIARY CARE HOSPITAL.
Ventilator-associated pneumonia (VAP) is the most common nosocomial infection diagnosed in the intensive care units (ICUs). Microorganisms responsible for ventilator associated pneumonia vary from place to place. VAP requires a rapid diagnosis and initiation of the antibiotic treatment.The present study was carried out to detect bacteria commonly associated with VAP and determine their susceptibility patterns including beta-lactamases production. Out of a total 1438 patients intubated for more than 48 hours, 302 patients (21.0%) were clinically diagnosed as VAP cases. The VAP rate was found to be 2.06 cases per 1000 ventilator days. A. baumannii (38.11%), P. aeruginosa (26.74%), K. pneumoniae (14.85%), S.aureus (11.38%), E. coli (3.96%), C. freundii (1.98%), A. lwoffi (1.98%) and P. mirabilis (0.99%) were isolated. Amongst the gram negative isolates, 15.64% were ESBL, 11.73% were AmpC and 13.96% were MBL producers. Early diagnosis of VAP along with their sensitivity pattern will help as an epidemiological marker for initial prophylaxis and treatment planning for mechanically ventilated patients.
2015
Background: Ventilator associated pneumonia is a major cause o f in hospital mortality and morbidity in our ICUs a nd it has received more importance with the advent of drug re sistance. The knowledge of local antibiotic suscept ibility patterns would guide the physician in the early empirical treatmen t of VAP. Our aim was to know the risk factors and microbial profile of Ventilator Associated Pneumonia patients. Methodology: We randomly studied 120 patients on ventilator in the 3 ICUs of KMC, Mangalore. VAP was diagnosed according to the case definition of VAP. The risk factors were analy zed and microbiological profile of patients who developed V AP was studied. Results: OF the 120 patients, 59 developed VAP. Prolonged ventilation and reintubation were the ris k factors most significantly associated with the de velopment of VAP. Gram negative organisms (acinetobacter, pseudomonas , klebsiella) were the most commonly isolated organ isms from specimens of VAP cases and there was hi...
Journal of Evolution of Medical and Dental Sciences
BACKGROUND Ventilator Associated Pneumonia (VAP) is an important infection most often encountered in mechanical ventilation (MV) patients in intensive care units in hospital. VAP occurs in approximately 9-27% of patients who are intubated. The morbidity and mortality associated with VAP is more inspite of recent advances in diagnosis and accurate management. Emergence of multidrug resistance among the pathogens causing VAP is also contributing to the outcome. We wanted to isolate the bacterial pathogens, study the antibiotic susceptibility pattern of the isolates and detect the presence of drug resistance in various pathogens. METHODS This is a retrospective, cross sectional study done on samples received between 2016 to 2018 among patients on MV for >/= 48 hours. Endotracheal aspirates were collected from 85 patients with assumed VAP, clinical pulmonary infection score (CPIS) was noted and aerobic quantitative cultures were performed on all samples. VAP was diagnosed by count of pathogenic organisms isolated >/= 10 5 cfu/mL. Identification and antibiotic susceptibility of the isolates were done as per the standard laboratory procedures. Patients with characteristic features i.e. clinical and radiological signs of pneumonia on admission were excluded from the study. RESULTS 50 cases were diagnosed as VAP by CPIS. Gender ratio was 30:20 (male to female) higher incidence 42% of VAP was seen in the age group of 46-60 years. Majority were Gram negative bacilli; 96%-Klebsiella 36%, Acinetobacter 26% E. coli 16%, Pseudomonas 14%, and Citrobacter 4% along with coagulase positive Staphylococcus in 4%. Of the 50 VAP patients, single organism was isolated in 92% and polymicrobial in 8%. Most of the isolates showed resistance to Amoxiclav, Cefepime, Cefixime and Meropenem. CONCLUSIONS Good compliance with VAP bundle adopted in critical care areas by the health care workers will reduce the incidence of VAP. Early and accurate diagnosis, appropriate empirical and specific antimicrobial use may significantly improve patient outcome.
BioMed Research International, 2014
Objective. We aimed to evaluate risk factors for ventilator-associated pneumonia (VAP) due toAcinetobacter baumannii(AbVAP) in critically ill patients.Methods. This was a prospective observational study conducted in an intensive care unit (ICU) of a district hospital (6 beds). Consecutive patients were eligible for enrolment if they required mechanical ventilation for>48 hours and hospitalization for>72 hours. Clinical, microbiological, and laboratory parameters were assessed as risk factors for AbVAP by univariate and multivariate analysis.Results. 193 patients were included in the study. Overall, VAP incidence was 23.8% and AbVAP, 11.4%. Previous hospitalization of another patient withAcinetobacter baumanniiinfection was the only independent risk factor for AbVAP (OR (95% CI) 12.016 (2.282–19.521)P<0.001). ICU stay(25±17versus12±9 P<0.001), the incidence of other infections (OR (95% CI) 9.485 (1.640–10.466)P=0.002)(urinary tract infection, catheter related infection,...
2019
Objective Ventilator associated pneumonia (VAP), which is a subset of hospital infections, occurs in patients who have been mechanically ventilated for at least 48 hours. The aim of this study was to determine the frequency of bacteria causing VAP and determine their antimicrobial susceptibility pattern.Results The present study is a cross-sectional descriptive study which was conducted in Shiraz during the 8 months (from November 2017 till June 2018). Samples were identified according to the diagnostic tests of bacteriology and antibiotic susceptibility test was performed using CLSI standards. 51 patients with VAP were examined, of which 10 and 8 patient respectively had chronic obstructive pulmonary disease and acute respiratory distress syndrome. The late onset VAP (61.7%) rate was more than compared to the early onset VAP rate (38.3%). The most frequently used antibiotics were meropenem (76.6%) and vancomycin (78.7%). Among 59 bacteria were isolated, Acinetobacter and Pseudomona...
2021
Ventilator-associated pneumonia (VAP) is a major health problem for people intubated in intensive care units (ICUs), leading to increased mortality rates, hospital stay, and treatment costs. In the present study, the core pathogens causing VAP in Beni-Suef University's Hospital, Egypt, was investigated over a study period of 2 years (2017–2019). Of a total of 213 patients subjected to mechanical ventilation, 60 have developed VAP during their stay in the ICU. The mortality rate reached 41.7% among VAP patients. Sixty bacteria were isolated from an endotracheal aspirate of hospitalized patients. The different isolates were cultured followed by running biochemical tests, sensitivity assays, and automated VITEK®2 System analysis. Unexpectedly, all the isolates were Gram-negative bacteria. Klebsiella pneumoniae were the main pathogen encountered (27/60 isolates) followed by Acientobacter baumannnii (7/60) and other microorganisms belonging to the genera Moraxella, Escherichia, and P...
Indian Journal of Anaesthesia, 2012
Background: Ventilator-associated pneumonia (VAP) is a common complication of ventilatory support for patients with acute respiratory failure and is associated with increased morbidity and mortality. Aim of the Study: The present study was undertaken to do quantitative cultures of aerobic bacteria, perform the antibiotic susceptibility testing from the endotracheal aspirates and clinical outcome of the clinically suspected patients of VAP. Methods: A prospective study was performed over a period of one year in a tertiary care hospital, enrolling patients on mechanical ventilation (MV) for ≥48 hr. Endotracheal aspirates (ETA) were collected from patients with suspected VAP, and direct gram's stain criteria was used to accept the sample. Quantitative cultures of ETA were performed with the threshold for microbiological diagnosis of VAP was taken as ≥10 5 colony forming units (cfu)/ml. Results: Out of 53 cases, 2 (3.77%) were polymicrobial. Multidrug resistant bacteria, mainly Acinetobacter baumannii 49.09% (27/55) and Pseudomonas aeruginosa 30.91% (17/55) were the most common pathogens isolated. Metallo-beta lactamases (MBLs) was produced by 47.06% (8/17) of Pseudomonas aeruginosa and 62.96% (17/27) of Acinetobacter baumannii. Conclusion: The bacteriological approach for the management of VAP helps the clinicians in choosing the appropriate antibiotics. This study showed that quantitative cultures of endotracheal aspirate at a cutoff point of 10 5 cfu/ml is one of the alternative to bronchoscopy in the diagnosis of clinically suspected ventilator associated pneumonia.
IP Innovative Publication Pvt. Ltd., 2017
Aim: To determine the bacteriology of mechanically ventilated patients and to know about incidence of ventilator associated pneumonia in a tertiary care hospital. Ventilator associated pneumonia is the commonest hospital acquired infection in ICUs. It is associated with increased morbidity and mortality of ICU patients. Early diagnosis of ventilator associated pneumonia is crucial to save the patient. Materials and Method: 100 patients who were admitted to medical ICU and were on mechanical ventilation for more than 48 hours were included in the study group. Under strict aseptic precautions endotracheal aspirates and suction tips were collected from the patients and were subjected to Gram staining, culture, biochemical tests and sensitivity. The patients were divided into early onset VAP and late onset VAP cases. VAP cases were identified by using clinical pulmonary infection scoring system. Results: Incidence of VAP in the study was 21%. There was no association between gender difference and incidence of VAP. All culture positive cases are not VAP cases. Among the isolates obtained Gram negative bacilli were the commonest, Acinetobacter taking the first place followed by Pseudomonas. Most of them were resistant to commonly used antibiotics.
Journal of natural science, biology, and medicine
Ventilator-associated pneumonia (VAP) is the most frequent Intensive Care Unit acquired infection. The aim is to determine the incidence, bacteriology and factors affecting VAP and to determine the multi-drug resistant (MDR) pathogens. This was a prospective observational study conducted over a period of 1 year from April 1, 2011, to March 31, 2012. The patients fulfilling criteria of VAP were included in this study. This was performed using SPSS trial version 11.0 software (SPSS Inc., Chicago, Illinois, USA) and the values of P < 0.05 were considered statistically significant. Totally 74 (27.71%) patients were developed VAP. Of total 74 patients with VAP 53 (71.62%) were females and 21 (28.37%) were females (P < 0.0001). Total 13 (17.56%) patients had early-onset VAP and 61 (82.43%) had late-onset VAP (P < 0.0001). The overall incidence of VAP rate per 1000 ventilator days was 39.59. Total 126 bacterial isolates found in 74 patients with VAP. Predominant isolates were Gram...