Study of vap in a tertiary care post graduate teaching institute in Rohilkhand region of north India

VAP is defined as development of bacterial pneumonia in patients on mechanical ventilation for > 48hrs. Lack of gold standard diagnostic criteria for VAP leads to either over-diagnosis (leading to overuse of antibiotics) or under-diagnosis (leading to delayed antibiotic use), both of which are potentially harmful situation for the patient. A review of literature shows only few studies have been published on VAP in ICU‘s of India. With growing incidence of resistance among organisms isolated in VAP, a combined approach of antibiotic restriction along with appropriate de-escalation therapy, effective surveillance and good infection control (isolation and barrier nursing practices) is essential if antibiotic resistance has to be overcome. Our present study was done with an aim to know the incidence of VAP (early and late) in our ICU, to evaluate the impact of VAP on duration of mechanical ventilation, length of ICU stay and mortality (outcome), to find out the organisms isolated and there antibiotic resistance pattern. With this knowledge, we aim to formulate a regional empirical antimicrobial policy which will help us in prompt initiation of appropriate antibiotic regimen and improve patient outcome.