Incidence, microbiological profile and early outcomes of ventilator associated pneumonia in elderly in a Tertiary Care Hospital in India

Kant, Ravi; Dua, Ruchi; Beg, Mirza Atif; Chanda, Reshmi; Gambhir, Indrajeet Singh; Barnwal, Shruti

doi:10.4103/2384-5589.153397

Cited by 6 publications

(6 citation statements)

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“…12 In a study by Kant et al among elderly patients,Acinetobacter (25.37%) was the most common isolate, followed by Pseudomonas (17.91%) and Staphylococcus aureus (17.91%). 13 In a south Indian study,Pseudomonas, E.coli, Klebsiella, Acinetobacter and Staphylococcus were reported as commonest isolates from VAP cases. 11 In a similar study by Garg N, Staphylococcus aureus (80%) was the most common gram positive isolate obtained from VAP followed by Enterococcus species (20%).…”

Section: Discussionmentioning

confidence: 98%

A Study on Bacterial Etiology of Ventilator Associated Pneumonia and its Antimicrobial Pattern

Narayanan¹,

Rajan²,

Sasikala³

et al. 2018

IJCMR

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Introduction: Ventilator Associated Pneumonia(VAP) remains a major cause of mortality and morbidity among critical ill patients. An imbalance between normal host defenses and the ability of microorganisms to colonize and invade the lower respiratory tract results in hospital acquired pneumonia. Aims and objectives were to isolate and identify bacterial pathogens from VAP and to determine their antibiogram. Material and Methods:A total of 66 Endotracheal aspirates were included in this study. 0.01 ml of sample was inoculated onto Blood agar,Chocolate agar and MacConkey agar and plates were incubated overnight at 37°C for 24 and 48 hours. Bacterial isolates were identified by standard biochemical tests. Antimicrobial sensitivity testing was performed on Muller Hinton Agar by Kirby Bauer disk diffusion and interpreted as per the Clinical and Laboratory Standards Institute (CLSI) guidelines. Results: The occurrence of VAP was more common in the age group of 18-30 years (46.51%). Of the total cases 59.09% showed monomicrobial growth and 6.06% showed polymicrobial growth. The predominant gram negative isolate obtained was Klebsiella sp (68.89%) followed by Acinetobacter sp(15.56%) and Pseudomonas aeruginosa (13.33%). Among the Gram negative bacilli, 24.44% were resistant to Piperacillin Tazobactam and 35.56% to Cefoperazone sulbactam and 31.11% isolates were resistant to meropenem.All gram negative isolates were sensitive to Imipenem. Conclusion: Knowledge on incidence of VAP, its etiology and susceptibility patterns is essential to initiate the empirical antibacterial therapy for patients on mechanical ventilation

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Section: Discussionmentioning

confidence: 98%

A Study on Bacterial Etiology of Ventilator Associated Pneumonia and its Antimicrobial Pattern

Narayanan¹,

Rajan²,

Sasikala³

et al. 2018

IJCMR

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“…While findings of the study done by Turković and collaborators demonstrated that Pseudomonas aeruginosa was identified in most of the patients (19.0%), Acinetobacter baumannii was identified in 13.6% patients, Escherichia coli in 8.1% patients and Klebsiella pneumonia was identified in 8.1% patients. Another study carried out in India by Kant and fellows, highlighted that Acinetobacter baumannii was identified among 25.4% patients, Pseudomonas aeruginosa among 17.9% patients, Klebsiella pneumonia among 10.4% patients and Escherichia coli among 8.9% patients [15,16].…”

Section: Discussionmentioning

confidence: 99%

Isolation and Antimicrobial Susceptibility Profile of Microorganisms Isolated from Ventilator Associated Pneumonia Patients

Cheema¹,

Saleem²,

Chaudary³

2018

J Infec Dis Treat

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Objectives: Ventilator-associated pneumonia (VAP) is the second most prevalent nosocomial infectivity in ICU and most frequent among mechanically ventilated patients. VAP is divided in the two groups based upon mechanical ventilation duration, early and late onset VAP. The most common pathogens in Pakistan were Acinetobacter lwoffi (22%), Staphylococcus aureus (33%) and Pseudomonas aeruginosa (63%). Improper antibiotic therapy has increased the frequency of MDR strains of the pathogens, further aggravating threat posed by disease. The objectives of the study were to identify the organisms up to species level and to determine the Minimum Inhibitory Concentration (MIC) of the isolated organisms by using VITEK.Methods: It was a descriptive study in which 74 patients having ventilator associated pneumonia i.e., patients who developed pneumonia after 48 hours of stay in intensive care unit of hospital were included. Collected Tracheobronchial secretions were sent to the pathology laboratory as soon as for culture and sensitivity. After initial identification of isolates, final identification/ confirmation was done by Vitek 2-compact system.Results: Among 74 patients, 51.0% were males and 54.0% were 51-60 years old. Major cause of ICU admission was head trauma and stroke. Among 72 patients, klebsiella pneumonia was identified in 37.0% patients, pseudomonas aeruginosa in 28.0% patients, acinetobacter baumannii in 21.0% patients and Escherichia coli was identified in 14.0% patients. Klebsiella pneumoniae was 100% resistant to piperacillin. Pseudomonas aeruginosa were 80% resistant to Ampicillin/salbactem. Acinetobacter baumanii was 100% resistant to ampicillin/salbactem, piperacillin, cefuroxime axetil, cefixime, ceftriaxone cefepime, aztreonam, meropenem, levofloxacin, moxifloxacin, trimethoprim. Similarly, E. coli was 60.0% resistant to ampicillin/ salbactem, piperacillin, cefuroxime, cefuroxime axetil, cefixime, ceftriaxone, cefepime, aztreonam, meropenem, levofloxacin, moxifloxacin and chloramphenicol. Conclusion:A very high prevalence of multi drug resistance organisms are noted among ventilator associated pneumonia at a teaching hospital in Pakistan.

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“…Most of the patients of VAP were present in the age group of more than 60 years (43.13%). The patients included in the study were admitted for various aetiologies, the most common admitting diagnosis of the patient is intentional self-harm/poisoning (37), sepsis/infectious causes (32) and cerebrovascular accidents (23) followed by acute exacerbation of COPD/bronchial asthma (19).…”

Section: Resultsmentioning

confidence: 99%

“…This was similar to other studies done by Kant et al where Acinetobacter was the most common organism. 19 Out of the total isolates in patients with VAP 39.2% cultures were mono microbial whereas 43.1% were polymicrobial and there was no growth in 17.6%. The increased incidence of Acinetobacter species could be due to its ability to grow in any kind of environment and to develop resistance to antibiotics and spread by aerosols.…”

Section: Microbiologymentioning

confidence: 94%

Incidence, determinants and outcomes of ventilator associated pneumonia in medical intensive care unit: a prospective cohort study from South Western India

Rao

Bhat

et al. 2021

Int J Res Med Sci

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Background: Ventilators are being increasingly used in developing countries as a result of which complications like ventilator associated pneumonia is also increasing. Present study is being undertaken to evaluate the impact of risk factors and their changing trends for Ventilator associated pneumonia.Methods: A prospective observational study was conducted in mechanically ventilated patients of medical intensive care unit from October 2013 to April 2015.Results: In present study 166 patients receiving mechanical ventilation in a medical ICU were observed. Incidence of VAP in present study is 43.5 for 1000 days of mechanical ventilation. The risk factors that were significant in the study are organ failure (p=0.001), emergency intubation (p=0.001), reintubation (p=0.023) and COPD (p=0.026). The common organisms responsible for VAP were Acinetobacter (30%), Klebsiella pneumoniae (27.1%) and Pseudomonas aeruginosa (20%). The mortality was higher in VAP group (31.3%) compared to the non VAP group (15.7%).Conclusions: There is high incidence of VAP in the developing countries. The risk factors that were found to be associated with VAP in the present study were the presence of COPD, reintubation, organ failure and emergency intubation. VAP is associated with significantly increased duration of hospital stay, morbidity and mortality.

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Incidence, microbiological profile and early outcomes of ventilator associated pneumonia in elderly in a Tertiary Care Hospital in India

Cited by 6 publications

References 1 publication

A Study on Bacterial Etiology of Ventilator Associated Pneumonia and its Antimicrobial Pattern

A Study on Bacterial Etiology of Ventilator Associated Pneumonia and its Antimicrobial Pattern

Isolation and Antimicrobial Susceptibility Profile of Microorganisms Isolated from Ventilator Associated Pneumonia Patients

Incidence, determinants and outcomes of ventilator associated pneumonia in medical intensive care unit: a prospective cohort study from South Western India

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