A study of ventilator associated pneumonia –risk factors and outcomes

Abstract

Background: Ventilator-associated pneumonia (VAP) is a serious nosocomial infection that occurs in mechanically ventilated patients, increasing morbidity, mortality, and healthcare costs. It is one of the most common ICU-acquired infections, with a significant impact on patient outcomes. Understanding the risk factors and microbial profile of VAP is crucial for improving prevention and treatment strategies. Aim: This study aimed to assess the prevalence, risk factors, microbiological profile, and outcomes of VAP in critically ill patients requiring mechanical ventilation. Materials and Methods: A prospective observational study was conducted on 175 mechanically ventilated patients in the medical ICU, fulfilling the inclusion criteria. Clinical data, risk factors, microbiological findings, and patient outcomes were analysed. Endotracheal cultures were performed, and antimicrobial susceptibility patterns were evaluated. Statistical analysis was conducted using SPSS version 20, with significance set at p<0.05. Results: The mean age of patients was 48.71 years, with a male preponderance (70.9%). The mean duration of mechanical ventilation was 11.1 days, and VAP was present in 74.3% of cases, with 44% classified as late-onset and 30.3% as early-onset VAP. The most common risk factors included emergency intubation (68.6%), impaired consciousness (64.6%), and prolonged mechanical ventilation (>7 days) (58.3%). The predominant pathogens were Acinetobacter baumannii and Klebsiella pneumoniae (20% each), with multidrug-resistant strains posing a significant challenge. High resistance was noted against cephalosporins, fluoroquinolones, and carbapenems, while Tigecycline remained highly effective (97.4% sensitivity). No significant difference in patient outcomes was observed between VAP and non-VAP groups, but prolonged ventilation, emergency intubation, and tracheostomy were significantly associated with VAP development (p<0.05). Conclusion: VAP remains a major ICU concern, with emergency intubation, prolonged ventilation, and tracheostomy being key risk factors. The high prevalence of multidrug-resistant organisms highlights the need for strict infection control measures and antimicrobial stewardship programs to improve patient outcomes.