Clinical, Microbiological and Mortality Profile in Ventilator-associated Pneumonia in a Tertiary Care Hospital in Western India

Abstract

Background. Ventilator-associated pneumonia (VAP) is a major cause of morbidity and mortality in patients on mechanical ventilation (MV). There is paucity of data in our country regarding incidence, crude mortality rate, clinical profile, microbiological organism profile, mortality in early and late onset VAP and mortality as well as appropriate antibiotic therapy in these patients.Methods. The study involved patients above 15 years of age with clinical suspicion of VAP, receiving MV for more than 48 hours in intensive care unit of our hospital. Patients were without evidence of pneumonia on admission. Study patients were followed until they were successfully treated and discharged from the hospital or death.Results. Out of 50 patients, 31 (62%) patients were in 4th to 6th decades of life. Incidence of VAP was 21% and crude mortality rate was 42%. Due to neurological conditions, 22 (44%) patients required MV. VAP developed in 38 (76%) patients within 15 days of initiation of MV. Mortality in late onset VAP was found to be twice as compared to mortality in early onset VAP. Mortality in inappropriately treated patients was significantly higher than that of appropriately treated patients.Conclusions. The incidence of VAP increases with increase in duration of hospital stay. There is significant morbidity and mortality in mechanically ventilated patients of VAP; if not treated appropriately early.