Prevalence and Clinical Profile of Ventilator Associated Pneumonia in Picu.

Abstract

Background and Objective: Ventilator-associated pneumonia (VAP) is second most common hospital acquired infection in patients who are on mechanical ventilation, which develops more than 48 hours after start of the mechanical ventilation. This study is to determine the incidence rate, bacteriological profile, antibiotic sensitivity pattern of ventilator associated pneumonia in paediatric intensive care unit (PICU). Materials and Methods: This is a prospective cross-sectional study. The study was conducted on patients admitted in PICU of Shri B. M. Patil Medical College Hospital and Research Centre, Vijayapura, Karnataka, India, between November 2018 and July 2020. Patients diagnosed with VAP based on the defined criteria were included in the study and were studied determine the incidence rate, bacteriological profile, antibiotic sensitivity pattern of ventilator associated pneumonia in our paediatric intensive care unit. Results: The incidence of VAP was 11/81 (13.58%) in our hospital. 98.76 % of patients had a sterile blood culture and 1.24 % (n=1) showed the presence of gram-negative bacilli. A majority of patients (87.65 %, n=71) had a sterile ET Tube culture, while 3.70 % patients (n=3) showed the presence of Klebsiella pneumoniae in ET Tube culture. Citrobacter frenudi and Staphylococcus aureus was detected in 2.47 %( n= ) of cultures, each. Pseudomonas aeruginosa, Escherichia coli and Acinetobacter was seen in 1.23 % (n=1) of neonates, each. Of the 81 enrolled patients, 76.54 % of the patients improved, while 9.88 % of patients were discharged against medical advice (n= 8). 13.58 % of patients (n= 11) had a fatal outcome. Of the patients who had VAP (n=11), 81.82 % improved with treatment, 9.09 % (n=1) were 11 DocuSign Envelope ID: 3366D8867E70F30--F803FB25--44363679--8A96F37B--A3874D8EF5095D97463FE1E discharged against medical advice and there was mortality of 9.09 % (n=1). The mortality in our study, attributable to VAP was 1/81 (1.23%). The ET tube isolates showed minimum resistance to Meropenem (30 %) and Vancomycin (20%) and maximum sensitivity to Meropenem (70 %) and Vancomycin (80%). CONCLUSION: Meropenem and Vancomycin were found to be the most appropriate antibiotics for the management of VAP in our hospital.