Incidence, clinical outcome, and risk stratification of ventilator-associated pneumonia-a prospective cohort study

Abstract

Context and Aim: Ventilator-associated pneumonia (VAP) remains to be the commonest cause of hospital morbidity and mortality in spite of advances in diagnostic techniques and management. This project aims to study the various risk factors and the common microbial flora associated with VAP. It also evaluates the use of APACHEIII scores for prognostication. Study Design: A prospective cohort study was conducted over 1 year in medical critical care unit (CCU) of a tertiary-care teaching hospital. Methods and Material: VAP was diagnosed using the clinical pulmonary infection score (CPIS) of more than 6. The study cohort comprised 51 patients. All CCU patients requiring mechanical ventilation for more than 48 h formed the study group. Statistical Analysis Used: Univariate analysis, χ 2-test, and paired "t-test." Results: Twenty four out of fifty-one cases developed VAP. These cases had an average APACHEIII score of more than 55 on admission to critical care unit (CCU). They needed prolonged mechanical ventilation and had lower PaO /FiO ratio as compared with the remaining patients who did not develop VAP. Pseudomonas aeroginosa 2 2 was the commonest and most lethal organism. The mortality in the VAP group was 37% and correlated very well with higher APACHEIII scores on admission. Conclusions: Longer duration of mechanical ven tilation and the need of reintubation are associated with proportionate rise in the incidence of VAP. Deterio rating PaO2/FiO ratio correlated well with the onset of VAP. Higher APACHEIII scores on admission 2 stratify the mortality risk.

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

“…The incidence of VAP in our study was 32% which was similar to a study conducted by Shalini et al and Rakshit et al 6,7 In relation to gender the incidence of VAP was more among males (65.62%) than females (34.38%) similar to the study of Gandani et al 8 In different age groups the incidence of VAP was highest in patients more than 45 years of age (56.25%).…”

Ventilator-associated pneumonia in a tertiary care hospital in India: role of multi-drug resistant pathogens

“…Pseudomonas spp., Acinetobacter spp., Escherichia coli, Klebsiella pneumoniae and Staphylococcus aureus were identified as the common VAP pathogens, with varying prevalence [5][6][7]. Up to 40% of these infections can be polymicrobial [3,8].…”

Antibiotic Susceptibility Pattern of Bacteria Isolated from Adult Patients with Ventilator Associated Pneumonia (VAP) in Intensive Care Units in a Tertiary Care Hospital

“…56.9% Present study 2014 60% [7] 20.0 30.0 23.3 26.7 Rakshit et al [8] 5.9 32.0 20.0 17.6 Joseph et al [13] 29. 8 21.3 6.4 14.9 Goel et al [16] 23.6…”

“…Mortality in VAP cases was 50.94%. [2] 2007 71.1% Gadani et al [6] 2010 62% Gupta et al [7] 2011 63.5% Rakshit et al [8] 2005…”