Incidence, Clinical and Microbiological Pattern of Ventilator Associated Pneumonia (VAP) In Neonatal Intensive Care Unit in Amritsar, India
Journal Title: INTERNATIONAL JOURNAL OF CURRENT RESEARCH IN MEDICAL SCIENCES - Year 2018, Vol 4, Issue 2
Abstract
Introduction: Ventilator Associated Pneumonia (VAP) is a pneumonia where the patient is on mechanical ventilation for >2 calender days on the date of event, with day of ventilator placement being on day 1 and the ventilator was in place on the date of event or the day before.VAP continues to be major threat to patients admitted in intensive care units and receiving mechanical ventilation. 86% of nosocomial pneumonias are associated with mechanical ventilation. VAP accounts for high mortality, morbidity and health care cost burden. Material and methods: The study was done on all intubated neonates in neonatal intensive care units (NICU), Bebe Nanki Mother and Child Care Centre attached to Government Medical College, Amritsar for a period of one year from February 2016 to January 2017. All interventions were recorded; Centre for Disease Control & Prevention (CDC) criteria were applied to find the incidence of VAP per 1,000 mechanical ventilation days. Cultures from tracheal aspirates and blood were done and analyzed. Results: Out of 116 cases analyzed, 22 (18.96%) developed VAP, incidence being 36.9/1000 mechanical ventilation days. The mean duration of ventilation before the onset of VAP was 132.45+78.15 hours. About two-third of the cases (63.64%) developed late onset VAP. Clinically, worsening of gas exchange on pulse oximetry, increases in oxygen and ventilation demand were most common features. X-rays of chest showed that 45.45% patients had new infiltrates and consolidation. Acinetobacter (80%) and Klebsiella (20%) were the most commonly cultured pathogens from tracheal aspirates. Conclusion: The incidence of VAP was higher as compared to developed countries; it needs interventions at various levels to bring it down. Use of preventive measures, early extubation, prevention of prematurity, empirical antibiotic use as per culture reports and improved nursing care can decrease VAP and hence neonatal mortality in our NICU.
Authors and Affiliations
*Manmeet Kaur Sodhi, **Gupta Anju Darshan Kumar, ***Karnail Singh, *Ashwani Kumar, ****Sita Malhotra, *****N. S. Neki
Keywords
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- EP ID EP551317
- DOI 10.22192/ijcrms.2018.04.02.005
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