A PROSPECTIVE MICROBIOLOGICAL STUDY FOR VENTILATOR ASSOCIATED PNEUMONIA IN A TERTIARY CARE HOSPITAL

T.K. Agasti*, M. Chauhan and K. Desai

ABSTRACT

This study was carried out to isolate and to identify the bacterial etiological agents associated with ventilator associated pneumonia (VAP) and to perform antimicrobial susceptibility tests of these bacterial isolates and to recommend proper use of antibiotics to reduce the mortality, morbidity and costs to the patients or hospitals resulting from VAP. 212 bronchoalveolar lavage (BAL) fluid from intubated and mechanically ventilated ICU patients and later 73 patients, out of these who developed VAP, were taken as samples. Bacteriological studies were performed on these samples. Among the bacterial causative agents Klebsiella, Pseudomonas, S.aureus and E.coli were found to be the commonest in patients with VAP. The most sensitive antimicrobial agents against the Gram -ve bacteria are piperacillin-tazobactam, meropenem, ceftazidime, ceftriaxone-tazobactam, kanamycin and tobramycin. The Gram +ve cocci were found to be most sensitive to meropenem, linezolid, piperacillin-tezobactam and levofloxacin. The selection of initial antimicrobial therapy, before the present microbiological report is available, is based predominantly emperically on previous pattern of microbiological profile and their sensitivity pattern to different antimicrobial agents which vary from ICU to ICU. But the earliest information, provided by the present microbiological examination of BAL fluid from patients suffering from VAP, will provide the earliest and appropriate antimicrobial therapy in the settings of life threatening infections in ICU.

Keywords: Ventilator associated pneumonia, Bronchoalveolar lavage, Kirby-Bauer, MRSA, ESBL, Klebsiella, Pseudomonas, E.coli.