A Study to Find out Incidence, Etiology, Diagnosis and Outcome of Ventilator Associated Pneumonia

  • Pawan Kumar Shukla Senior Resident, Dept. of Pulmonary Medicine, Baba Saheb Ambedkar Medical College and Hospital, Rohini, Delhi
  • Santosh K Jha
Keywords: Ventilator Associated Pneumonia, hospital-acquired pneumonia

Abstract

Background: Ventilator-associated pneumonia (VAP) is defined as pneumonia that occurs 48-72 hours or thereafter following endotracheal intubation. VAP contributes to approximately half of all cases of hospital-acquired pneumonia . VAP is estimated to occur in 9-27 % of all mechanically ventilated patients. Hence the present study was undertaken to study incidence, etiology, diagnosis and outcome VAP.

Methods: A total of 100 patients who will be kept on mechanical ventilator will be selected in an intensive care unit (ICU). Cases included will be patients of both sexes who were kept on mechanical ventilator for more than 48 h, having the age of >14 years. Informed Written consent will be obtained from all the study subjects. A detailed clinical evaluation including thorough history, physical and general examination will be done on each subject.  Growth >105 CFU/ml was taken as the cut-off threshold for ETAs while growth >104 CFU/ml was taken as the cut-off for BAL. All patients who will be included in the study will be monitored at frequent intervals (every three days) for the development of VAP using clinical and microbiological criteria until either discharge or death. The clinical parameters will be recorded from their medical records and bedside charts. Details of antibiotic therapy, surgery, use of steroids, duration of hospitalization, presence of neurological disorders, and impairment of consciousness will also be noted. 

Results: Out of 100 patients VAP was found to be in 43 patients . in early onset VAP pseudomonas aeruginosa and acinetobactor baumanii are the chief causative organisms (36% each) .in late onset VAP pseudomonas, klebsiella were most common causative organisms(52% each) followed by acinetobactor baumanii.

Conclusions: This proves that non-invasive ventilatory support is an effective tool in the management of acute exacerbation of COPD.

Downloads

Download data is not yet available.

References

1. Davis KA. Ventilator-associated pneumonia: a review. J Intensive Care Med 2006;21:211 -26.
2. Koenig SM, Truwit JD. Ventilator-associated pneumonia:diagnosis, treatment, and prevention. Clin Microbiol Rev2006;19:637-57.
3. Zack JE, Garrison T, Trovillion E, et al. Effect of an education program aimed at reducing the occurrence of ventilator.
4. Luna,C.M.,P.Vujacich,M.S.Niederman,C.Vay,C.Gherardi,J.Matera, and E. C. Jolly. 1997. Impact of BAL data on the therapy and outcome of ventilator-associated pneumonia. Chest 111:676–685
5. Kerver AJ, Rommes JH, Mevissen-Verhage EA, Hulstaert PF, Vos
A, Verhoef J, Wittebol P. Colonization and infection in surgical
intensive care patients: a prospective study. Intensive Care Med
1987;13: 347–351.
6. Kollef MH. Ventilator-associated pneumonia. A multivariate
analysis. JAMA 1993;270:1965–1970
7. Timsit JF, Chevret S, Valcke J, Misset B, Renaud B, Goldstein
FW, Vaury P, Carlet J. Mortality of nosocomial pneumonia in
ventilated patients: influence of diagnostic tools. Am J Respir Crit
Care Med 1996;154:116–123.
8. Tejada Artigas A, Bello Dronda S, Chacon Valles E, Munoz Marco
J, Villuendas Uson MC, Figueras P, Suarez FJ, Hernandez A. Risk
factors for nosocomial pneumonia in critically ill trauma patients.
Crit Care Med 2001;29:304–309
9. Rodriguez de Castro F, Sole-Violan J, Aranda Leon A, Blanco
Lopez J, Julia-Serda G, Cabrera Navarro P, Bolanos Guerra J. Do
quantitative cultures of protected brush specimens modify the
initial empirical therapy in ventilated patients
10. Craven DE, Kunches LM, Kilinsky V, Lichtenberg DA, Make BJ,
McCabe WR. Risk factors for pneumonia and fatality in patients
receiving continuous mechanical ventilation. Am Rev Respir Dis
1986;133:792–796.
11. Torres A, Gatell JM, Jimenez P, Gonzalez J, Ferrer A, Celis R,
Rodriguez-Roisin R. Incidence, risk, and prognosis factors of
nosocomial pneumonia in mechanically ventilated patients. Am
Rev Respir Dis 1990;142:523–528
12. Erbay RH, Yalcin AN, Zencir M, Serin S, Atalay H. Costs and risk factors for ventilator-associated pneumonia in a Turkish university hospital’s intensive care unit: A case-control study. BMC PulmMed 2004;4:3
13. Lee K, Lee WG, Uh Y, Ha GY, Cho J, Chong Y. VIM- and IMP type metallo-beta-lactamase-producing Pseudomonas spp. and Acinetobacter spp. in Korean hospitals. Emerg Infect Dis 2003;9:868-71.
14. Quale J, Bratu S, Landman D, Heddurshetti R. Molecular epidemiology and mechanisms of carbapenem resistance in Acinetobacter baumannii endemic in New York city. Clin Infect Dis 2003;37:214-20.
Published
2019-12-24
How to Cite
1.
Shukla PK, Jha SK. A Study to Find out Incidence, Etiology, Diagnosis and Outcome of Ventilator Associated Pneumonia . Int Arch BioMed Clin Res [Internet]. 2019Dec.24 [cited 2020Sep.18];5(4):PM4-PM6. Available from: https://iabcr.org/index.php/iabcr/article/view/539
Section
ORIGINAL ARTICLES ~ Pulmonary Medicine