Ventilator-Associated Pneumonia : A Clinico-Micribiological study of Causative Organism and their Antibiotic Susceptibility Pattern

Abstract

Background: Ventilator Associated Pneumonia (VAP) is defined as pneumonia that occurs 48 hours or more after endotracheal intubation or tracheostomy, caused by infectious agents not present or incubating at the time mechanical ventilation started. High mortality and healthcare costs area associated with ventilator-associated pneumonia (VAP) due to Multidrug-Resistant (MDR) Pathogens. Aim: To identify the relation of risk factors for ventilator-associated pneumonia (VAP) and mortality with the drug resistance profile. Materials and Method: A total of 38 isolates from 35 VAP patients were collected during the study. They were processed following standard laboratory protocol. Antibiogram was done using appropriate antibiotics by Kirby-Bauer disc diffusion method and the occurrence of MRSA, ESBLs and MBLs was seen. Results: Males were most commonly affected, and Acinetobacter spp. Were the most common organism isolated. For MDR isolates most sensitive drug was Cefoperazone-sulbactum, followed by Piperacillin-tazobactam, Piperacillin and Cefoperazone. Whereas in non-MDR isolates Amikacin was most sensitive followed by both Cefoperazone-sulbactum and Gentamicin . Most common mechanism of resistance among MDR isolates was found to be Carbapenemase production, followed by AmpC, and ESBL. Diabetes mellitus was most common risk factor, followed by smoking, and alcohol. Majority of patients had leucocytosis and some were anaemic. Conclusion: Periodic analysis of Sputum culture and their antibiotic sensitivity report should be made to identify the changing trends in etiological and sensitivity patterns.