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Article type :

Original Article

Author :

Imran Khan M, Sabarigirivasan Harish V. K, Loknath B

Volume :

12

Issue :

1

Abstract :

Introduction: Ventilator Associated Pneumonia (VAP) is the second most common nosocomial infection in the United States, with high mortality and morbidity. Duration of hospital stay increased in average of 7 to 9 days with increase in treatment cost of $40,000 per patient. However, clinical evidence on the incidence of this infection is poor, especially from ICUs in India. Aim: To study the incidence, risk factors and etiological agents in ICU patients developing VAP in a tertiary care hospital in India. In this study, patients who were kept on ventilator for more than 48 hours in ICU were enrolled. To clinically diagnose VAP, the modified clinical pulmonary infection score (CPIS) and clinical criteria were used as a screening tool. A full clinical history of the patients was documented, as well as the date of admission to the ICU, the date of initiation of mechanical ventilation, and the method of access to the patients' airway. A standard PROFORMA was used and the collected data was observed and analysed further. Results: In the present study out of 45 patients enrolled for the study, only 6 patients (13.3%) showed VAP. The presence of early VAP was observed in 3 patients whereas late VAP was also observed in 3 patients. The male and female patients exhibited similar incidences of VAP. The patients with an age group more than 70 years showed a maximum (37.5%) prevalence of VAP. Clinical features like fever and increased amount of secretions were found to be associated with the occurrence of VAP. Smoking and diseases like hypertension, kidney disease, malignancy and chronic lung disease were non-significantly associated with VAP. Whereas disease states like coma and enteral nutrition were found to be significantly associated with VAP. Acinetobacter and Klebsiella were the most common organisms isolated in our institution. Conclusion: VAP remains a significant concern to patients admitted to an ICU for mechanical ventilation, highlighting the critical need for preventive measures.