Bacteriology profile among patients with ventilator-associated pneumonia from a medical intensive care unit at a tertiary care center in Mumbai

Set, Reena; Bobade, Omprakash; Shastri, Jayanthi

doi:10.4103/0377-4929.81622

Cited by 5 publications

(5 citation statements)

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“…Klebsiella species accounted for 25% followed by Acinetobacter species (18.75%) and Pseudomonas (18.75%) similar to a study by Reena set et al 9 Staphylococcus aureus (15.62%) was the commonest among the gram positive isolates followed by Coagulase negative staphylococci (9.37%) and Pneumococci (6.25%). Two isolates were yeast species (6.25%).…”

Section: Vap Is An Important Nosocomial Infection In Patients On Mechsupporting

confidence: 68%

A clinico - microbiological study in patients undergoing mechanical ventilation in a tertiary care hospital

et al. 2016

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Section: Vap Is An Important Nosocomial Infection In Patients On Mechsupporting

confidence: 68%

A clinico - microbiological study in patients undergoing mechanical ventilation in a tertiary care hospital

et al. 2016

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“…Three Candida nonalbicans and one Candida albicans was also isolated. The findings are similar to a study by Set et al 9 Klebsiella pneumoniae was also reported as the commonest isolates by Rajshekar et al 10 and Krishnamurthy et al 11 In present study, 3 (9.6%) Staphylococci were isolated, out of which 2 (6.4%) were methicillin resistant Staph. aureus (6.45%).…”

Section: Discussionsupporting

confidence: 92%

Untitled

2019

MIJMIC

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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.

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“…The VAP rate per 1000 ventilator days is a commonly used parameter worldwide, and although its rate was quite low in the USA (4.4) 4 , in various other countries, it was found to be high in the range of 13-51 per 1000 ventilator days 5 . In various studies from India, the VAP rates were 22.9 from Puducherry 7 and 26 and 27.77, respectively, from two separate studies from Mumbai 19 20 . In the initial two years of our study, the VAP rates were high (44.1 and 43.8 per 1000 ventilator days), but could be brought down to 26.3 per 1000 days in 2013.…”

Section: Discussionmentioning

confidence: 99%

Antibiotic resistance & pathogen profile in ventilator-associated pneumonia in a tertiary care hospital in India

Chaudhury

Rani

Kalawat

et al. 2016

Indian Journal of Medical Research

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Background & objectives:Ventilator-associated pneumonia (VAP) is an important hospital-acquired infection with substantial mortality. Only a few studies are available from India addressing the microbiological aspects of VAP, which have been done with small study populations. This study was carried out in the intensive care units (ICUs) of a tertiary care hospital to assess the profile of pathogens and to determine the pattern of antimicrobial resistance.Methods:This was a retrospective study of clinically suspected cases of VAP. Over a three year period, a total of 247 cases in 2011, 297 in 2012 and 303 in 2013 admitted in ICUs on mechanical ventilation with clinical evidence of VAP were included in our study. The endotracheal aspirate samples from these suspected cases were subjected to quantitative culture technique, and colony count of ≥105 colony forming units/ml was considered significant. Antimicrobial susceptibility test for the isolates was done.Results:VAP rates of 44.1, 43.8 and 26.3 were seen in 2011, 2012 and 2013, respectively. In all the three years, non-fermentative Gram-negative bacilli were the predominant organisms, followed by Pseudomonas spp. and Klebsiella spp. Staphylococcus aureus exhibited a downwards trend in prevalence from 50.0 per cent in 2011 to 34.9 per cent in 2013. An increase in vancomycin-resistant enterococci was seen from 4.3 per cent in 2012 to 8.3 per cent in 2013, while methicillin resistance amongst the S. aureus crossed the 50 per cent mark in 2013. An increasing trend in resistance was shown by Pseudomonas spp. for piperacillin-tazobactam (PTZ), amikacin and imipenem (IPM). For the non-fermenters, resistance frequency remained very high except for IPM (33.1%) and polymyxin-B (2.4%).Interpretation & conclusions:Our findings show VAP as an important problem in the ICU setting. The incidence of multidrug-resistant pathogens was on the rise. The resistance pattern of these pathogens can help an institution to formulate effective antimicrobial policy. To have a comprehensive pan-India picture, multicentric studies are needed.

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Bacteriology profile among patients with ventilator-associated pneumonia from a medical intensive care unit at a tertiary care center in Mumbai

Cited by 5 publications

References 0 publications

A clinico - microbiological study in patients undergoing mechanical ventilation in a tertiary care hospital

A clinico - microbiological study in patients undergoing mechanical ventilation in a tertiary care hospital

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Antibiotic resistance & pathogen profile in ventilator-associated pneumonia in a tertiary care hospital in India

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