BACTERIOLOGICAL PROFILE OF VENTILATOR ASSOCIATED PNEUMONIA IN A TERTIARY CARE CENTRE OF DAKSHINA KANNADA DIST.
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2017, Vol 6, Issue 80
Abstract
BACKGROUND Mechanical ventilation can increase the risk of VAP 7 - 21 times and 10% - 25% of patients undergoing mechanical ventilation develop pneumonia. The aetiological agents of VAP vary with different patient populations and types of ICUs. Prompt administration of appropriate antibiotics seems to be the only intervention that alters outcome once the diagnosis is established. MATERIALS AND METHODS This is a descriptive study with seventy-four non-repetitive endotracheal aspirate from patients who were on mechanical ventilation for more than 48 hrs. and in whom ventilator associated pneumonia was suspected using modified CPIS score and quantitative culture was confirmed using modified two-fold dilution scheme. Kirby-Bauer disk diffusion method was adopted for antimicrobial susceptibility testing. RESULTS The most common isolate was pseudomonas aeruginosa (27%) followed by Acinetobacter spp. (20.3%), Klebsiella spp. (16.2%) and E. coli (12%). Among gram positive bacteria in our study, only Staphylococcus aureus (9.5%) was isolated. Amikacin and levofloxacin were found to be better against non-fermenters; 10% were carbapenemase producers, MDR isolates were observed in enterobacteriaceae members. MRSA was found in 28.6%. CONCLUSION In conclusion, the incidence of VAP and the prevalence of multidrug resistant microorganisms were quite high in our ICU setup. A local surveillance program at each centre is essential, as the knowledge of local resistant patterns is vital for selecting the appropriate agents for treating infections
Authors and Affiliations
Sateesh K, Sathya Anandam, Vidya Pai
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