Incidence of ventilator associated pneumonia (VAP) in neuro ICU, in a Tertiary Hospital

Abstract

Background: Ventilator-associated pneumonia (VAP) is the most common nosocomial infection diagnosed in the intensive care unit (ICU), in spite of advances in diagnostic techniques and management it remains a common cause of hospital morbidity and mortality. Early and rapid diagnosis and initiation of the appropriate antibiotic treatment reduce mortality and decrease the development of MDR organisms. Objective: To determine the incidence of ventilator-associated pneumonia (VAP) and its effect on patients’ outcome. Materials and Methods: A retrospective study was conducted in Enam Medical College Savar, Dhaka. The study group consisted of patients who received mechanical ventilation in the Neuro-surgery ICU from January 2021 to December 2021. The study group consisted of patients who received mechanical ventilation in the Neuro-surgery ICU from January 2021 to December 2021 and developed pneumonia before 48 hours of intubation. Patients records were taken from the ICU and their detailed reports. Data were collected using a structured questionnaire containing all the variables of interest. Data was processed and analyzed with the help of computer program SPSS for windows version 25. Results: This study shows the mean age of the participants was 32.88±18.47 years with a range of 4 to 75 years. Majority (76%) were male and 24% were female (24%). Common co-morbidity was hypertension (14%) followed by diabetes mellitus (12%) and 8% were DM with HTN. It observed that severe traumatic brain injury case was the most common underlying condition (58%). Staph aures (42%) accounted for the highest number of cases followed by Klebseila (26%) and E. coli (26%). Clindamycin was the most common sensitivity pattern of antibiotic in ventilator associated pneumonia (VAP). Majority (90%) were good prognosis, 6% were bad prognosis and 4% were lung fibrosis. Conclusions: This study shows most common pathogens causing VAP were Staph aures then Klebseila and E. coli. Clindamycin was the most common sensitivity pattern of antibiotic in ventilator associated pneumonia (VAP). Therefore, it is important to frame local antibiotic policies and precautions to prevent VAE in the future.

JBSA 2023; 36 (1) : 4-8