Clinical study of ventilator-associated pneumonia in tertiary care hospital, Kolhapur, Maharashtra, India

Abstract

Background: Ventilator‑associated pneumonia (VAP) is the most common nosocomial infection acquired by patients admitted in the intensive care unit (ICU). However, there is very less information or clinical data available on the occurrence of VAP in Kolhapur, Maharashtra.Methods: study aims to determine the Incidence of VAP in ICU, to study the association between causative microorganism and sensitivity, and to study the association between prognosis and incidence of VAP. Settings and Design: Tertiary level, medical‑surgical ICU; prospective, observational study.Results: Patients coming to Medicine Department of the hospital subjected to mechanical ventilation for more than 48 hours in critical Care Facility during the period of two years May 2014 to April 2016.Conclusions: In the incidence of VAP was found to be 78% among ICU patients. Majority (36%) patients had diabetes mellitus, 30% had hypertension before the admission. It is observed that chances of developing VAP were more in patients with co-morbid conditions. The microbiological results of Endotracheal Aspirate showed that, majority 36% had pseudomonas, 26% had Acinetobacter, 22% had no growth, 14% staphylococci (Staphylococcus is a gram-positive, round-shaped bacterium that is a member of the Firmicutes, and is frequently found in the nose, respiratory tract, and on the skin), 2% proteus mirabilis as compared to similar studies. Out of all, Pseudomonas is the most commonly isolated organism. This could be attributed to decreased immunity and a compromised general condition due to associated illness. Also, prolonged hospital stay is also of significance.

Ventilator associated pneumonia: unravelling prevalence risk factor and antibiotic usage

“…majority of bacteria's isolated in our study were gram negative bacteria Enterobactar, Klebsiella pneumonia and Klebsiella oxytoca had 16.7% growth Pseudomonas aeruginosa had 13.3% growth and Acinetobacter and E. coli having 3.3% growth it is compared with Deshmukh et al, endotracheal aspirate showed that, majority 36% had Pseudomonas, 26% had Acinetobacter, 22% had no growth, 14% Staphylococci, 2% Proteus mirabilis 9. …”

Complete Closed-Loop Ventilatory Circuit Delays the Onset of Ventilator-Associated Pneumonia in Mechanically Ventilated Neurological Patients in the ICU: A Single-Center Prospective Preliminary Study

“…In the existing literature, the incidence of VAP has been reported in the wide range of 5 to 78%. [7][8][9][10] This disparity to a certain extent could be attributed to the different VAP definitions and different ICU setups with heterogeneous patient conditions such as medical, surgical, neurological, etc., which may have affected the reported VAP incidence.…”

“…Based on the Indian literature, at the tertiary care center ICU which included neuro-medical patients, the reported VAP incidence was 78%. 7 Another study reported 57.14% of VAP incidence which found to increase to 76% in trauma cases and 85.1% in patients requiring MV > 15 days. 8 Based on this literature, we assumed VAP incidence of 60% in our neuro-medical cases and aimed to reduce it to 30%, and with a study power of 80% and a type 1 error rate of 5%, the calculated sample size for each group was 42.…”

HUBUNGAN LAMA PENGGUNAAN VENTILATOR MEKANIK DENGAN MORTALITAS DI INTENSIVE CARE UNIT (ICU) RSUD Dr. H. ABDUL MOELOEK

“…Diantara komorbid yang bersifat kronik, sirosis (p 0,011) memiliki risiko hazard paling tinggi, sedangkan pada komorbid akut, peritonitis (p 0,001) dan gangren (0,027) memiliki risiko tertinggi. 13…”