Ventilator-associated Pneumonia: A Prospective Observational Study.

BACKGROUND

The danger of ventilator-associated pneumonia (VAP) is maximum in the early course of a hospital stay. The published Indian data on VAP are limited.

OBJECTIVES

The primary objectives were to find the occurrence and clinical outcome of VAP in the intensive care unit (ICU), whereas the secondary objectives were to find risk factors and microbiological profile of VAP.

MATERIALS AND

METHODS

About 138 patients admitted to ICU who were intubated for >48 hours were enrolled in this prospective observational study. Risk factors such as age, chronic lung disease, length of mechanical ventilation (MV), clinical outcome, presence of nasogastric tube, previous antibiotic exposure, reintubation or intubation ≥7 days, change in the ventilator circuit, and use of sedatives/paralytic agents were noted. The endotracheal aspirate was sent to the laboratory for species identification and sensitivity testing. Discrete and continuous variables were compared by Fisher's exact test and Mann-Whitney U test, respectively. Multiple logistic regression analysis was done to explore the significant risk factors linked with VAP.

RESULTS

The occurrence of VAP was 34.7/1,000 MV days, whereas 21.7% of MV patients developed VAP. Mortality was 50% in VAP patients. Age >55 years, prolonged ventilation, and chronic lung disease were significantly associated with VAP. The most common isolate was Acinetobacter baumannii, followed by Klebsiella pneumoniae. Multidrug resistance (MDR) and extensive drug resistance were observed in 13.3 and 66.7% of isolates, respectively.

CONCLUSION

There was a high incidence and mortality of VAP in ICU patients. Strict implementation of VAP bundles and adherence to infection control protocols are needed.