Microbiological profile and its resistance pattern in cases of Ventilation Associated Pneumonias

Abstract

Introduction:According to the WHO, respiratory infections are the first leading cause of death in low income countries and third leading cause of deaths worldwide. Ventilator associated pneumonia (VAP), an important  form  of hospital acquired  pneumonia  specially  refers   to  pneumonia  developing in mechanically ventilated patients more than 48 hours after tracheal intubation ortracheostomy.Objectives: 1.To study the microbiological profile among clinically and radiologicaly diagnosed VAPcases.2.To study the bacterial profile in these cases.3.To study the antibiotic susceptibility pattern of bacteria associated with VAP.Material and methods:Endotracheal aspirate of 120 clinically and radiologically suspected patients were collected and was subjected to microscopy, culture and antimicrobial susceptibility testing. Results:Maximum number of cases of VAP were found on day 5 i.e late onset cases were more prevalent in our study(61.66%). Pathogens were 75.8%, colonisers were 16.93% and sterile samples were 7.25%. Monomicrobial flora was more common in both pathogenic(75.5%) and coloniser group(66.66%).Klebsiella was most common in pathogenic monomicrobial(44.68%) group while E. Coli was more common in coloniser monomicrobial group(23.8%). Good sensitivity was found for imipenem but resistance was common for tetracycline, trimethoprim-sulfamethoxazole and cephalosporins. Methacillin resistance Staphylococcus aureus was found in 75% cases. Conclusion:Gram negative isolates were more common than Gram positive. Significant resistance was noted for tetracycline, trimethoprim-sulfamethoxazole and cephalosporins. As VAP is leading cause of mortality and morbidity,cases should be diagnosed and treated as soon as possible.