Finding the Incidence of Ventilator Associated Pneumonia by Recent NHSN Guidelines and Its Bacteriological Profile: A Study Conducted in a Tertiary Care Hospital in Southern India

Fatima, Sandra de; Rao, Suchitra; Shailaja, V.V.; Nagamani, K.

doi:10.20546/ijcmas.2019.810.242

Cited by 2 publications

(4 citation statements)

References 5 publications

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“…The incidence of VAP by recent NHSN guidelines and its bacteriological profile have been thoroughly described in our previously published article (6). Generally, 31 (15.19%) patients developed VAP during their ICU stay.…”

Section: Resultsmentioning

confidence: 99%

“…Oxygen demand on the ventilator was measured by the fraction of inspired oxygen or positive end-expiratory pressure. Criteria for defining ventilator-associated conditions (VAC), infection-related ventilator-associated complications (IVAC), and possible VAP were considered by recent NHSN guidelines as described in our previous article (6).…”

Section: Criteria For Vap Diagnosismentioning

confidence: 99%

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Role of Multidrug-resistant Pathogens in Ventilator-Associated Pneumonia in a Tertiary Care Hospital in India

Fatima

Uddin

Rao

et al. 2022

Avicenna J Clin Microbiol Infect

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Aim: Ventilator-associated pneumonia (VAP) is the second most common infection acquired in the intensive care unit (ICU). Bacteriological profiles cause VAP and their susceptibility patterns vary in different institutions. Methods: A prospective study was conducted from June 2017 to May 2018 in a tertiary care hospital as per the recent NHSN guidelines in finding the incidence of VAP and further determining the etiological agents by both conventional and automated methods. The combination disk method (Phenotypic confirmatory test), ampicillin C (AmpC) disk test, modified carbapenem inactivation method, imipenem/ethylenediamine tetraacetic acid combined disc test, and cefoxitin disk test were performed for the detection of extended-spectrum beta-lactamases (ESBL), AmpC β-lactamases, carbapenemases, metallo-beta-lactamases (MBL), and methicillin-resistant Staphylococcus aureus, respectively. Results: Among 104 patients, 31 cases developed PVAP (possible VAP) during their ICU stay; of these cases, two patients had two episodes of VAP each, and the incidence of VAP was 32%. The most common isolate was Acinetobacter baumannii (38%), followed by Pseudomonas aeruginosa (22%), Klebsiella pneumoniae (16%), and Escherichia coli (13.51%). Twenty (54%) of the 37 VAP pathogens were multidrug resistant. ESBL was produced by 40% and 67% of E. coli and K. pneumoniae, respectively. MBL was produced by 25% of P. aeruginosa. In addition, AmpC beta-lactamases were produced by 18% each of the Enterobacteriaceae and non-fermenters, respectively. One of the two S. aureus isolates was methicillin-resistant. Conclusion: The majority of VAP cases in our setting were caused by highly resistant strains. The frequency of specific multidrug resistance pathogens causing VAP may vary due to hospital, patient population, exposure to antibiotics, type of ICU patients, and changes over time, emphasizing the need for timely local surveillance data.

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Section: Resultsmentioning

confidence: 99%

Section: Criteria For Vap Diagnosismentioning

confidence: 99%

Role of Multidrug-resistant Pathogens in Ventilator-Associated Pneumonia in a Tertiary Care Hospital in India

Fatima

Uddin

Rao

et al. 2022

Avicenna J Clin Microbiol Infect

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“…The risk for Ventilatory Associated Pneumonia is greatest at 3% per day for the first five days,2% per day for 6-10 days,1% per day after day 10. The attributable risk of death has decreased and is more recently estimated at 9-13% largely because of the implementation of preventive strategies [3][4][5][6][7][8] . VAP is typically characterized by fever, purulent secretions, leukocytosis, increased respiratory rate, decreased tidal volume, and increased minute ventilation.…”

Section: Introductionmentioning

confidence: 99%

“…Whereas, Positioning for ICU patients plays a vital role. There are certain positions the promote the development of VAP and it is important for clinicians to understand that gastroesophageal reflux and pulmonary aspiration of oropharyngeal contents, even clearance of airway secretions can be highly affected by body positioning 3 . Elevation of the head end of the bed minimum of 30 degrees was used as a preventive strategy to lower the risk of aspiration 10 .…”

Section: Introductionmentioning

confidence: 99%

Effects of Various Degrees of Semi-Recumbent Positioning in Prevention of Ventilator-Associated Pneumonia

Shanmugananth

Tsmo

Rekha

et al. 2022

Int J Life Sci Pharm Res

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Ventilator-associated pneumonia (VAP) is one of the common complications occurring in patients predominantly in intensive care units. It is a respiratory tract infection that develops in patients who are intubated for more than 48 hours to 72 hours. It is commonly caused by pseudomonas aeruginosa, If the infection occurs within the first 48 to 72 hours, it is called “earlyonset” and if after 72 hours is termed as “late-onset”1. Even though there are innumerable methods to decrease the infection and its associated morbidity we wanted to examine whether any changes in position were effective in its reduction. The experimental study was conducted on 30 samples collected in a consecutive manner. The study was performed in the Intensive care unit of a medical college hospital for a period of 2 months. The study included both male and female patients between 18 – 55 years who underwent mechanical ventilation for >48 hrs. Following inclusion criteria, patients were screened and randomly divided into 3 equal groups, Group A (35-degree recumbency), Group B (40-degree recumbency), and Group C (45-degree recumbency). The degree was measured by a protractor which was confirmed with available protractor software. The pre and the post (Clinical Pulmonary Infection Scores) CPIS scores were noted. The demographic variables were similar between the groups. There was a significant reduction of scores in Group B and C than A (p value <0.001) there were no major side effects. There were no dropouts. We conclude that both 40-degree and 45-degree recumbency significantly decrease CPIS scores than 35 degrees. Even though Group C is better than group B it’s statistically insignificant.

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Finding the Incidence of Ventilator Associated Pneumonia by Recent NHSN Guidelines and Its Bacteriological Profile: A Study Conducted in a Tertiary Care Hospital in Southern India

Cited by 2 publications

References 5 publications

Role of Multidrug-resistant Pathogens in Ventilator-Associated Pneumonia in a Tertiary Care Hospital in India

Role of Multidrug-resistant Pathogens in Ventilator-Associated Pneumonia in a Tertiary Care Hospital in India

Effects of Various Degrees of Semi-Recumbent Positioning in Prevention of Ventilator-Associated Pneumonia

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