Untitled

Abstract

Background: VAP is a most common nosocomial infection in the intensive care unit. Knowledge of causative organisms and their antibiotic susceptibility is crucial for diagnosis of VAP in order to initiate the appropriate antibiotic treatment thereby. Aim: To isolate and identify the causative organisms of VAP in ICU patients and also their resistance pattern. Material and Methods: All patients on mechanical ventilation for more than 48 hours were included in the study. The diagnosis of VAP was established using clinical pulmonary infection score (CPIS). Endotracheal aspirate was collected under aseptic precautions after 48 hours of intubation whenever patient was suspected to have developed VAP in ICU and was immediately taken to the laboratory for processing. Results: Out of the 100 cases, VAP was diagnosed in 31 cases. Thus, the incidence of VAP in our study was 31%. Out of total 24 microorganisms isolated, Klebsiella pneumoniae 13 (41.9%) was the most common organism isolated followed by Acinetobacter spp. 6 (19.3%), Pseudomonas aeruginosa 4 (12.9%). Out of the 13 Klebsiella pneumoniae isolates, 11 (84.6%) isolates of Klebsiella pneumoniae were resistant to 3rd generation cephalosporins. Among the 6 isolates of Acinetobacter spp. 4 (33.3%) were resistant to all antibiotics tested. Three Pseudomonas aeruginosa strains were resistant to Piperacillin + tazobactum, Ceftazidime, Cefepime and Ciprofloxacin. Conclusion: This study shows the emergence of MDR Klebsiella pneumoniae, Acinetobacter spp. and Pseudomonas aeruginosa, as potential pathogens causing VAP in our ICU. Combined clinical and microbiological prevention strategies such as rational antibiotic therapy, timely surveillance, strict infection control measures are needed to reduce incidence of VAP.