Incidence of Ventilator-associated Pneumonia and Impact of Multidrug-Resistant Infections on Patient’s Outcome: Experience at an Apex Trauma Centre in North India

Khurana, Surbhi; Mathur, Purva; Kumar, Subodh; Soni, Kapil Dev; Aggrawal, Richa; Batra, Priyam; Bhardwaj, Nidhi

doi:10.4103/ijmm.ijmm_16_186

Cited by 10 publications

(3 citation statements)

References 18 publications

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“…The study done by Khurana et al in North India also showed similar results. 16 49.10% Pseudomonas aeruginosa isolates showed resistance to ceftazidime and 54.55% to ciprofloxacin. Similar results were documented in a study conducted by Ilkunur Erdem et al which showed 59% of Pseudomonas aeruginosa isolates were resistant to ceftazidime and 62% to ciprofloxacin.…”

Section: Discussionmentioning

confidence: 99%

Bacteriological profile and antimicrobial resistance pattern of ventilator associated pneumonia in tertiary care hospital

Rajesh¹,

Katragadda²,

Ramani³

2021

IJMR

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With an occurrence ranging from 6-52%, ventilator-associated pneumonia (VAP) is the most common ICU acquired infection, accounting for a significant portion of hospital-acquired infections (HAIs). VAP is pneumonia that develops after a period of more than 48 hours of mechanical ventilation or endotracheal intubation. To isolate and identify the potential pathogens causing VAP and to study their antimicrobial susceptibility patterns. Endotracheal aspiration (ETA) or bronchoalveolar lavage (BAL) were collected from patients on mechanical ventilation >48 hours. Bacterial isolates were identified based on culture colony characteristics and biochemical parameters. Antibiotic susceptibility profile was determined for these isolates by Kirby-Bauer disc diffusion method as per Clinical and laboratory Standards Institute (CLSI) 2020 guidelines and studied. The collected data was entered in Excel, and analyzed by using SPSS version 16. Among the isolates, the most common were (31.31%) and (31.31%). These were followed by (22.22%), (7.07%), (3.03%) and (3.03%) and (2.02%).Multi Drug Resistant (MDR) microbes causing VAP are on the increase. The patient population at risk will benefit by the application of the results of this study. The antibiotic resistance pattern of these isolates will aid clinicians in selecting the appropriate antimicrobial agents. Hence, it can lead to decreased mortality and morbidity due to life-threatening VAP.

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Section: Discussionmentioning

confidence: 99%

Bacteriological profile and antimicrobial resistance pattern of ventilator associated pneumonia in tertiary care hospital

Rajesh¹,

Katragadda²,

Ramani³

2021

IJMR

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“…Knowledge of its affliction in India is limited to a few clinical studies [14][15][16][17] and fewer environmental studies 15,18 . There is a need to prioritize studies on this unexplored pathogen as the rates of ventilator associated pneumonia is fairly larger in India 19,20 . Though conventional culture technique is considered the gold standard for detection, use of molecular techniques like PCR have proven to increase the sensitivity for clinical diagnosis of Legionella [21][22][23][24] .…”

Section: Discussionmentioning

confidence: 99%

Genetic Diversity of the Legionella pneumophila dotA Gene Detected on Surfaces of Respiratory Therapy Equipment

Vittal¹,

Kumar²,

Karunasagar³

et al. 2021

J Pure Appl Microbiol

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Legionellosis is a neglected disease due to the absence of well-defined clinical symptoms and difficulties in isolating the causal organism. Legionella spp. is known to colonize the lumen of respiratory therapy equipment(RTE) and evade conventional detection by entering the viable but non-culturable state. Monitoring these surfaces for Legionella pneumophila in addition to routine monitoring of water could aid in decreasing incidences of hospital-acquired infections by this pathogen. In this study swabs of different respiratory therapy equipment were tested for the presence of Legionella by conventional culture-based methods versus molecular detection of culture-independent template by polymerase chain reaction (PCR). Genetic diversity of the genes amplified were studied using bioinformatic tools. The dotA genes were genetically diverse indicating no clonality. This communication highlights that the persistence of virulence genes like dotA on abiotic surfaces can result in the mobilization of these genes to other species and give rise to virulent forms especially in a healthcare setting.

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“…However, the lack of monitoring of the individual compliance with these strategies may hide the role of unmeasured confounding factors. Another prospective study by Khurana et al, designed to assess the impact of VAP and MDR germs on critically ill patients, highlighted the inverse correlation between VAP incidence and preventive measures compliance (ventilator bundle plus hand hygiene) trends [ 89 ]. Again, the decline in VAP rate observed in young and old patients admitted to French ICUs between 2007 and 2014 (aIRR 95%CI 0.88, 0.82–0.94, p < 0.001 and 0.89, 0.81–0.98, p = 0.022, respectively) was partially explained by the improvement of ventilator bundle adherence over time [ 90 ].…”

Section: Combining the Strategiesmentioning

confidence: 99%

Pathogenesis-Targeted Preventive Strategies for Multidrug Resistant Ventilator-Associated Pneumonia: A Narrative Review

et al. 2020

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Ventilator-associated pneumonia (VAP) is the most common hospital-acquired infection in the intensive care unit (ICU), accounting for relevant morbidity and mortality among critically ill patients, especially when caused by multidrug resistant (MDR) organisms. The rising problem of MDR etiologies, which has led to a reduction in treatment options, have increased clinician’s attention to the employment of effective prevention strategies. In this narrative review we summarized the evidence resulting from 27 original articles that were identified through a systematic database search of the last 15 years, focusing on several pathogenesis-targeted strategies which could help preventing MDR-VAP. Oral hygiene with Chlorhexidine (CHX), CHX body washing, selective oral decontamination (SOD) and/or digestive decontamination (SDD), multiple decontamination regimens, probiotics, subglottic secretions drainage (SSD), special cuff material and shape, silver-coated endotracheal tubes (ETTs), universal use of gloves and contact isolation, alcohol-based hand gel, vaporized hydrogen peroxide, and bundles of care have been addressed. The most convincing evidence came from interventions directly addressed against the key factors of MDR-VAP pathogenesis, especially when they are jointly implemented into bundles. Further research, however, is warranted to identify the most effective combination.

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Incidence of Ventilator-associated Pneumonia and Impact of Multidrug-Resistant Infections on Patient’s Outcome: Experience at an Apex Trauma Centre in North India

Abstract: Isolation of MDR pathogens from bronchoalveolar lavage does not always adversely affect the outcome of patients. It requires an interdisciplinary team of clinical microbiologists, physicians and hospital infection control nurses, to collectively manage these patients.

Cited by 10 publications

References 18 publications

Bacteriological profile and antimicrobial resistance pattern of ventilator associated pneumonia in tertiary care hospital

Bacteriological profile and antimicrobial resistance pattern of ventilator associated pneumonia in tertiary care hospital

Genetic Diversity of the Legionella pneumophila dotA Gene Detected on Surfaces of Respiratory Therapy Equipment

Pathogenesis-Targeted Preventive Strategies for Multidrug Resistant Ventilator-Associated Pneumonia: A Narrative Review

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