Antimicrobial resistance of bacterial isolates from respiratory secretions of ventilator associated pneumonia in the intensive care units of a tertiary care hospital

Background: Ventilator-associated pneumonia (VAP) contributes to approximately half of all cases of hospital-acquired pneumonia. VAP is estimated to occur in 9–27 % of all mechanically ventilated patients. Due to increase in incidence of drug resistance among the VAP isolates, correct diagnosis is a challenge for an accurate management. Aim: The aim of the study was to isolate the causative agents for VAP in patients on mechanical ventilation and determine their antibiotic susceptibility testing and also Study the risk factors associated with VAP in critically ill patients admitted in ICUs. Material & Method: This prospective observational study was conducted in the intensive care units (ICUs) from July to Dec 2015 undergoing mechanical ventilation for >48hrs. Endotracheal aspirates were collected from patients suspected VAP and quantitative cultures were performed .VAP was diagnosed on the basis of CPIS score. Results: The incidence of VAP in our study was 34.61% and incidence rate of VAP was 46.65 per 1000 ventilation days.83.83% (83/99) isolates were from MICU and predominant VAP pathogens were Acinetobacter spp. (51.75%) . Acinetobacter baumanii and Enterobacteriaceae were the prevalent MDR isolates. This might be attributed to prolong hospital stay and improper cleaning of the tubes. Conclusion: Increase in VAP cases with the potential drug resistant organisms is an emerging threat in our ICUs. Quantitative culture of endotracheal aspirate is a useful test for diagnosis of VAP and also help to determine the drug resistance in ICUs.