Bacteriological profile of ventilator-associated pneumonia in a tertiary care hospital
Background: Ventilator-associated pneumonia (VAP) is the most frequent intensive care unit (ICU)-acquired infection. The etiology of VAP and their antimicrobial susceptibility pattern varies with different patient populations and types of ICUs. Materials and Methods: An observational cross-sectional...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2018-01-01
|
| Series: | Indian Journal of Pathology and Microbiology |
| Subjects: | |
| Online Access: | http://www.ijpmonline.org/article.asp?issn=0377-4929;year=2018;volume=61;issue=3;spage=375;epage=379;aulast=Patro |
| _version_ | 1818391945247981568 |
|---|---|
| author | Somi Patro Gitanjali Sarangi Padma Das Ashoka Mahapatra Dharitri Mohapatra Bimoch Projna Paty Nirupama Chayani |
| author_facet | Somi Patro Gitanjali Sarangi Padma Das Ashoka Mahapatra Dharitri Mohapatra Bimoch Projna Paty Nirupama Chayani |
| author_sort | Somi Patro |
| collection | DOAJ |
| description | Background: Ventilator-associated pneumonia (VAP) is the most frequent intensive care unit (ICU)-acquired infection. The etiology of VAP and their antimicrobial susceptibility pattern varies with different patient populations and types of ICUs. Materials and Methods: An observational cross-sectional study was performed over a period of 2 years in a tertiary care hospital to determine the various etiological agents causing VAP and to detect the presence of multidrug-resistant (MDR) pathogens in these VAP patients. Combination disk method, Modified Hodge test, ethylenediaminetetraacetic acid disk synergy test, and AmpC disk test were performed for the detection of extended-spectrum beta-lactamase (ESBL), carbapenemases, metallo-beta-lactamases (MBL), and AmpC beta-lactamases, respectively. Results: The prevalence of VAP was 35%. Enterobacteriaceae (66.66%) and Staphylococcus aureus (20%) were common in early-onset VAP, while nonfermenters (50%) and Enterobacteriaceae (40.61%) were predominant from late-onset VAP. Nearly 60.87% of the bacterial pathogens were MDR. ESBL was produced by 21.74% of Enterobacteriaceae. AmpC β-lactamase was positive in 35.29% nonfermenters and 26.08% Enterobacteriaceae. MBL was positive in 17.64% nonfermenters and 17.39% Enterobacteriaceae. Among the S. aureus isolates, 75% were cefoxitin resistant. Prior antibiotic therapy (P = 0.001) and hospitalization of 5 days or more (P = 0.001) were independent risk factors for VAP by MDR pathogens. polymyxin B, tigecycline, and vancomycin were the most sensitive drugs for Gram-negative and positive isolates respectively from VAP. Statistical Analysis: SPSS for Windows Version SPSS 17.0 (SPSS Inc., Chicago, IL, USA) and Chi-square with Yates correction. Conclusion: Late-onset VAP is increasingly associated with MDR pathogens. Treatment with polymyxin B, tigecycline, and vancomycin should be kept as last-line reserve drugs against most of the MDR pathogens. |
| first_indexed | 2024-12-14T05:21:35Z |
| format | Article |
| id | doaj.art-f62a7e63c0ed4f94820c83c6ab7ab464 |
| institution | Directory Open Access Journal |
| issn | 0377-4929 |
| language | English |
| last_indexed | 2024-12-14T05:21:35Z |
| publishDate | 2018-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Indian Journal of Pathology and Microbiology |
| spelling | doaj.art-f62a7e63c0ed4f94820c83c6ab7ab4642022-12-21T23:15:39ZengWolters Kluwer Medknow PublicationsIndian Journal of Pathology and Microbiology0377-49292018-01-0161337537910.4103/IJPM.IJPM_487_16Bacteriological profile of ventilator-associated pneumonia in a tertiary care hospitalSomi PatroGitanjali SarangiPadma DasAshoka MahapatraDharitri MohapatraBimoch Projna PatyNirupama ChayaniBackground: Ventilator-associated pneumonia (VAP) is the most frequent intensive care unit (ICU)-acquired infection. The etiology of VAP and their antimicrobial susceptibility pattern varies with different patient populations and types of ICUs. Materials and Methods: An observational cross-sectional study was performed over a period of 2 years in a tertiary care hospital to determine the various etiological agents causing VAP and to detect the presence of multidrug-resistant (MDR) pathogens in these VAP patients. Combination disk method, Modified Hodge test, ethylenediaminetetraacetic acid disk synergy test, and AmpC disk test were performed for the detection of extended-spectrum beta-lactamase (ESBL), carbapenemases, metallo-beta-lactamases (MBL), and AmpC beta-lactamases, respectively. Results: The prevalence of VAP was 35%. Enterobacteriaceae (66.66%) and Staphylococcus aureus (20%) were common in early-onset VAP, while nonfermenters (50%) and Enterobacteriaceae (40.61%) were predominant from late-onset VAP. Nearly 60.87% of the bacterial pathogens were MDR. ESBL was produced by 21.74% of Enterobacteriaceae. AmpC β-lactamase was positive in 35.29% nonfermenters and 26.08% Enterobacteriaceae. MBL was positive in 17.64% nonfermenters and 17.39% Enterobacteriaceae. Among the S. aureus isolates, 75% were cefoxitin resistant. Prior antibiotic therapy (P = 0.001) and hospitalization of 5 days or more (P = 0.001) were independent risk factors for VAP by MDR pathogens. polymyxin B, tigecycline, and vancomycin were the most sensitive drugs for Gram-negative and positive isolates respectively from VAP. Statistical Analysis: SPSS for Windows Version SPSS 17.0 (SPSS Inc., Chicago, IL, USA) and Chi-square with Yates correction. Conclusion: Late-onset VAP is increasingly associated with MDR pathogens. Treatment with polymyxin B, tigecycline, and vancomycin should be kept as last-line reserve drugs against most of the MDR pathogens.http://www.ijpmonline.org/article.asp?issn=0377-4929;year=2018;volume=61;issue=3;spage=375;epage=379;aulast=PatroMultidrug resistantrisk factorsventilator-associated pneumonia |
| spellingShingle | Somi Patro Gitanjali Sarangi Padma Das Ashoka Mahapatra Dharitri Mohapatra Bimoch Projna Paty Nirupama Chayani Bacteriological profile of ventilator-associated pneumonia in a tertiary care hospital Indian Journal of Pathology and Microbiology Multidrug resistant risk factors ventilator-associated pneumonia |
| title | Bacteriological profile of ventilator-associated pneumonia in a tertiary care hospital |
| title_full | Bacteriological profile of ventilator-associated pneumonia in a tertiary care hospital |
| title_fullStr | Bacteriological profile of ventilator-associated pneumonia in a tertiary care hospital |
| title_full_unstemmed | Bacteriological profile of ventilator-associated pneumonia in a tertiary care hospital |
| title_short | Bacteriological profile of ventilator-associated pneumonia in a tertiary care hospital |
| title_sort | bacteriological profile of ventilator associated pneumonia in a tertiary care hospital |
| topic | Multidrug resistant risk factors ventilator-associated pneumonia |
| url | http://www.ijpmonline.org/article.asp?issn=0377-4929;year=2018;volume=61;issue=3;spage=375;epage=379;aulast=Patro |
| work_keys_str_mv | AT somipatro bacteriologicalprofileofventilatorassociatedpneumoniainatertiarycarehospital AT gitanjalisarangi bacteriologicalprofileofventilatorassociatedpneumoniainatertiarycarehospital AT padmadas bacteriologicalprofileofventilatorassociatedpneumoniainatertiarycarehospital AT ashokamahapatra bacteriologicalprofileofventilatorassociatedpneumoniainatertiarycarehospital AT dharitrimohapatra bacteriologicalprofileofventilatorassociatedpneumoniainatertiarycarehospital AT bimochprojnapaty bacteriologicalprofileofventilatorassociatedpneumoniainatertiarycarehospital AT nirupamachayani bacteriologicalprofileofventilatorassociatedpneumoniainatertiarycarehospital |