To study the clinical profile, etiology and outcome of ventilator associated pneumonia. A one year cross-sectional study

Abstract

Background and objectives ABSTRACT Hospital-associated pneumonia (HAP) is an infection of the lungs, usually due to bacterial, viral, or fungal pathogens, that is defined to occur greater than 48 hours after hospital admission. The present study was undertaken to assess clinical profile, risk factors and outcome in patients with ventilator associated pneumonia in critical care units and to find the etiology of ventilator associated pneumonia. Methodology The present one year cross sectional study was conducted in the Department of Medicine, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belgaum on 53 patients with VAP during the period of January 2010 to December 2010. The diagnosis of VAP was made according to clinical and laboratory finding based on Clinical Pulmonary Infections Score. Results A bimodal distribution of age was observed. 35.84 % of them developed bilateral and 35.85 % of them developed right sided pneumonia. Acinetobacter was the most common organisms isolated in early VAP (47.62%) and pseudomonas (57.14%) in late VAP. Among all the patients (100%) supine position and stress ulcer prophylaxis was identified as risk factor. 90.56% of patients developed VAP with in the first two weeks. 11 of the 13 patients who were greater than 60 years expired. Mortality in late onset VAP was 59.38% and early onset VAP was 23.81%. Out of the Acinetobacter and Pseudomonas X isolated majority of them were multidrug resistant isolates. Out of the 17 isolates of Pseudomonas 47.06% of them were metallo-beta lactamase producers. Interpretation and conclusion The incidence of patients who are being admitted to ICU and requiring mechanical ventilation is increasing. Knowledge of incidence of VAP, risk factors and their causative microbial flora in a local setting would be important to ensure more effective utilization of antibiotics and thereby, a better outcome.