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Ventilator-associated pneumonia (VAP) refers to pneumonia developing in a patient on mechanical ventilator >48 hours after intubation or tracheostomy. VAP is an important cause of morbidity and mortality in mechanically ventilated patients. The aim of the study was to assess the clinical and bacteriological profile of VAP, risk factors, prevalence of multidrug-resistant pathogens in VAP cases in ICU setting and to correlate Endotracheal aspirate (ETA) with blood culture in those cases. The study included 130 adult patients of both sexes who were admitted to ICUs and fulfilling the criteria of VAP. Endotracheal aspirates (ETA) and blood samples were collected from the suspected VAP cases and subjected to culture and antimicrobial susceptibility testing as per standard protocol. Incidence of VAP was found to be 40.8%, out of which 81.13% had late-onset VAP. Diabetes mellitus, advancing age (>60 years) and Chronic Obstructive Pulmonary Disease were the important risk factors associated with VAP. The most frequently isolated microorganism was Acinetobacter species (70.37%), followed by Pseudomonas aeruginosa (14.81%) and Klebsiella pneumoniae (5.56%). All Acinetobacter species and 75% of Pseudomonas aeruginosa isolates were multidrug resistant. Overall carbapenem resistance was 46%. Blood culture results were positive for 47.16% cases of VAP of which 76% showed bacteraemia of pulmonary origin. Acinetobacter species (33.96%) was the most common isolate from blood. Mortality in VAP cases was 50.94%. Due to the increasing incidence of multidrug-resistant organisms in ICUs, early and correct diagnosis of VAP is an urgent challenge for an optimal antibiotic treatment and cure. Hence, knowledge of the local microbial flora causing VAP and effective infection control practices are essential to improve clinical outcome.

journal of medical science and clinical research

Antibiotic Susceptibility Pattern of Bacteria Isolated from Adult Patients with Ventilator Associated Pneumonia (VAP) in Intensive Care Units in a Tertiary Care Hospital