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Study of ventilator associated pneumonia in tertiary care hospital, central vidarbha

Author: 
Dr. Sarika P. Kombade and Dr. Gopal N. Agrawal
Subject Area: 
Health Sciences
Abstract: 

Introduction: Ventilator associated pneumonia (VAP) is a type of nosocomial pneumonia which occurs in patients who receive mechanical ventilation (MV). In India, occurrence of VAP among intensive care unit (ICU) patients varies from 9% to 24%. Global crude mortality rate of VAP ranges from 24% to 50%. Aims and objectives: To determine the incidence rate, bacteriological profile and antibiotic sensitivity pattern of VAP. To determine Multidrug resistance pattern among the isolates. Materials and methods: 245 ICU infected patients who were on MV > 48 hours were studied prospectively in the Department of Microbiology, Indira Gandhi Govt. Medical College from Sep. 2010- Dec. 2012. After the clinical confirmation according to CDC criteria, the endotracheal secretion were collected and processed as per standard microbiological methods and antibiotic sensitivity pattern of each were recorded. ESBL, AMPC, MBL along with MRSA were detected. Results: Of total 107 clinically and microbiological diagnosed VAP patient, 114 isolates were obtained. Most common Organism isolated are Pseudomonas aeruginosa (33.6%), Acinetobactor spp. (29.9%), Klebsiella pneumoniae (26.2%) and Gram positive coccii (8.4%). Maximum gram negative isolates were sensitive to imipenem followed by piperacillin-tazobactum and amikacin. All Staphylococcus and Enterococcus species were sensitive to vancomycin and linezolid. High MDR were obtained. Conclusion: Due to the increasing incidence of multidrug-resistant organisms in our ICU, early and correct diagnosis of VAP is an urgent challenge for an optimal antibiotic treatment and cure. Hence, knowing the local microbial flora causing VAP and effective infection control practices are essential to improve clinical outcomes.

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