A study on clinical profile of ventilator associated pneumonia (vap) and antibiotic sensitivity pattern at a tertiary care hospital

Background and objectives :Ventilator associated pneumonia(VAP) is a hospital acquired infection(HAI) seen among critically ill patients on mechanical ventilation due to various causes in intensive care units(ICUs). It is associated with increased morbidity and mortality which increases the cost of health care. The objective of our study was to determine the clinical profile, organisms isolated and antibiotic susceptibility pattern in VAP patients in a tertiary care hospital.
Materials and methods: In this cross sectional prospective study,40 patients who developed features of ventilator associated pneumonia on a platform of mechanical ventilator for >48 hrs in ICU were included in the study.VAP was then diagnosed based on clinical pulmonary infection scoring system(CPIS) with a score of >=6.
Results: The incidence density rate of VAP was 21.875 per 1,000 ventilator days. Most of the patients had late onset VAP (60.7%) with average number of days of onset, of around 8 days.
Pseudomonas spp. and Acinetobacter, whereas Enterobacteriacea and, Staphylococcus aureus were commonly isolated organisms. Polymicrobial infections were not detected. Antibiotics like colistin, tigecycline and beta-lactamases were the most commonly effective antibiotics. Prior antibiotic therapy (P < 0.0001), hospitalization for 5 days or more (P < 0.0001), MV for 5 days or more (P < 0.0001), supine head position (P < 0.0001), reintubation (P = 0.0012) and impaired consciousness (P = 0.0191) were significant risk factors for VAP.
Conclusion :Ventilator associated pneumonia is associated with a significant increase in length of stay in ICU, time of mechanical ventilation, different complications and certain risk factors which further worsens the prognosis.