JOURNAL OF CLINICAL AND BIOMEDICAL SCIENCES

Abstract

Background: Ventilator associated pneumonia (VAP) is one of the most important form of hospital acquired infections which is associated with increased mortality and morbidity. VAP occurs in about 9 to 27% of all intubated patients. Intubation is associated with 3 to 10 fold increase in the incidence of VAP among all patients receiving mechanical ventilation. In contrast to other nosocomial infections, the crude mortality rate occurring due to VAP ranges from 24% to 76%. ICU patients with VAP have a 2 to 10-fold higher risk of death when compared with patients without pneumonia. The present study is undertaken to find out the frequency of occurrence of VAP in clinically suspected patients who are mechanically ventilated for more than 48 hours at R. L. Jalappa Hospital and Research Centre, Kolar and the major pathogens causing VAP and their antibiotic sensitivity pattern. Methods: A total of hundred patients who are mechanically ventilated for more than 48 hours with clinical suspicion of VAP were included in the study. Endotracheal aspirate was collected and subjected to Grams stain and culture. Culture was performed by quantitative culture technique. Growth on the culture plate was identified by standard biochemical reactions and subjected to antibiotic sensitivity testing by Kirby Bauer disc diffusion method. Results: Among the 100 clinically suspected VAP patients enrolled in the study 71% patients were diagnosed with VAP as per the CPIS score with a VAP rate of 17-22/1000 patient ventilated days. The most common age group affected was 31- 40 years with male preponderance. The mean duration of ventilation was 5.38 days. 26.76% of the infections were categorized as early onset VAP while 73.3% as late onset VAP. Conclusion: Acinetobacter was the most common organism causing both early onset and late onset VAP.

Key words: Early onset, Late onset, VAP