A study on factors associated with ventilator associated pneumonia at a tertiary care hospital

Background: Ventilator-associated pneumonia (VAP), an important form of hospital-acquired pneumonia (HAP), specifically refers to pneumonia developing in a patient on mechanical ventilator for more than 48 h after intubation or tracheostomy. Despite the advancements in antimicrobial regimes, VAP continues to be an important cause of morbidity and mortality. VAP requires a rapid diagnosis and initiation of appropriate antibiotic treatment, as there is adverse effect of inadequate antibiotic treatment on patient’s prognosis and the emergence of multidrug-resistant (MDR) pathogens. Objective: 1) To study microorganism pattern of VAP. 2) To identify associated factor for VAP. Methods: A prospective cross-sectional study was carried out in tertiary care hospital, Ahmedabad, over a period of 1 year. Total 40 patients selected by convenient sampling who were admitted in medical ICU during study period. Analysis was done by using statistical methods to identify the risk factors for morbidity and mortality associated with VAP. Results: Incidence was found to be higher amongst male patients (65%).Present study showed that out of 40 patients 21 (52.5%) patients died. Average duration of stay in ICU was 9 days. The most common organism found was Acinetobacter in 11 (27.5%) of patients. The major risk factor for VAP was Diabetes mellitus (15, 37.5%) followed by tracheostomy (12, 30.0%), re-intubation (9, 22.5%), elder patients (6, 15.0%), and shock in first two days (4, 10.0%). Conclusion: The incidence of VAP remains high and varies depending on the cause and period of intubation and underlying morbidity. Greater efforts should be made to prevent, diagnose and manage infection early and appropriately to reduce patient suffering and reduce the burden on hospitals providing services. Proper knowledge of risk factors can help identify high-risk groups.