Clinical and Microbiological Profile of Ventilator-Associated Pneumonia in Intensive Care Unit of Tertiary Care Hospital
Year: 2024
Type: article
Abstract: Introduction: In patients on mechanical ventilation, ventilator-associated pneumonia (VAP) is a frequent hospital-acquired ailments that raises mortality, intensive care unit stays, and medical expenses. The main cause of VAP is the aspiration of oropharyngeal organisms into the distal bronchi, which can happen directly or by stomach reflux. In order to effectively manage this illness, preventative measures are essential. Methods: In Central India, a Medical College Hospital served as the study’s setting. Patients were chosen from ICUs according to inclusion and exclusion criteria after receiving approval from the institutional ethical committee. Clinical, microbiological, and radiological indicators were taken into consideration when assigning a score to clinically suspected patients using the Chronic Pulmonary Infection Score (CPIS), in accordance with CDC guidelines. Age, gender, CPIS, diagnosis at ICU admission, length of ventilation, antibiotics received, samples submitted for etiological agent confirmation, suction tip culture, endotracheal aspirate, type of organism recovered, susceptibility profile, and clinical outcome were among the variables noted for each patient. Results: Out of the 362 patients that were chosen, 99.7% of them were in the supine position as their major risk factor, 99.44% had a nasogastric tube in place, and 98.1% were sedated. 39.23% of the patients experienced VAP following a minimum of 48 hours of intubation and mechanical ventilation. For patients who acquired VAP, the average length of time they were on mechanical ventilation was 9.09 ± 2.747 days. Just 1.56% of the isolated bacteria were gram-positive, whereas gram-negative bacteria made up the majority of the isolates (98.44%). Acinetobacter Baumannii (21.09%) and Klebsiella pneumoniae (41.40%) were the two most prevalent of the 128 identified species. Compared to patients without VAP, individuals with VAP experienced much longer stays in the ICU and hospital. Conclusion: The present study offers a thorough examination of the epidemiology, microbiological etiology, antibiotic resistance, and clinical consequences of ventilator-associated pneumonia (VAP). The majority of VAP cases are caused by gram-negative bacteria, which are MDR. The primary causal agent of VAP in the current study, K. pneumoniae, did not have a common source of infection that would have indicated possible endogenous origins. The results highlight the need for customized preventive and treatment plans to enhance patient outcomes and support continued monitoring and evidence-based methods to combat this difficult illness.
Authors: Pooja Sidam Panthakey, Shweta Thakur, Shilpa Kocheker
Language: English
Topic: Nosocomial Infections in ICU
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W6949557463
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