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International Journal of Current Microbiology and Applied Sciences (IJCMAS)
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National Academy of Agricultural Sciences (NAAS)
NAAS Score: *5.38 (2020)
[Effective from January 1, 2020]
For more details click here

ICV 2019: 96.39
Index Copernicus ICI Journals Master List 2019 - IJCMAS--ICV 2019: 96.39
For more details click here

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PRINT ISSN : 2319-7692
Online ISSN : 2319-7706
Issues : 12 per year
Publisher : Excellent Publishers
Email : editorijcmas@gmail.com / submit@ijcmas.com
Editor-in-chief: Dr.M.Prakash
Index Copernicus ICV 2018: 95.39
NAAS RATING 2020: 5.38

Int.J.Curr.Microbiol.App.Sci.2017.6(7): 3864-3879
DOI: https://doi.org/10.20546/ijcmas.2017.607.398


Ventilator Associated Tracheobronchitis: Incidence, Etiology, Predisposing Risk Factors and Drug Resistance
K.S. Mayuri*
Sagar Hospitals, Banashakari, Shavige Malleshwara Hills, Kumarswamy Layout, DSI Campus, Bangalore- 560078, India
*Corresponding author
Abstract:

Ventilator-associated tracheobronchitis (VAT) is common in incubated patients and is associated with increased morbidity, mortality, and health-care costs. Ventilator- associated tracheobronchitis (VAT) has been proposed as an intermediate condition between simple colonization of the upper airways and VAP. The present study is undertaken to determine incidence, bacterial etiology, predisposing risk factors and antibiotic sensitivity pattern of Ventilator associated tracheobronchitis, in patients admitted to ICU of S.S. Institute of Medical Sciences and Research Centre. Consecutive non duplicated endotracheal aspirate cultures from 365 patients on ventilator for more than 48 hours were included in the present study. VAT was diagnosed with standard criteria with a colony count of more than 106cfu/ml of endotrahceal aspirate. Only first episodes of VAT were included in the study. Endotracheal aspirates collected were subjected to gram stain and culture. Culture was performed by quantitative culture technique. Growth on the culture plate was identified by standard microbiological techniques and subjected to antibiotic sensitivity by Kirby Bauer disc diffusion method and CLSI guidelines. Among the 365 cases enrolled to different ICUs 61 patients were diagnosed to have VAT based on standard criteria. The incidence of VAT in the present study was reported to be 16.7%. It was verified that 9.8% of the patients had polymicrobial infection. Gram negative bacilli showed up as the most common pathogens overall. Most common pathogens isolated were P. aeruginosa (29%) and K. pneumoniae (26%). Previous imipenem therapy, COPD, CCF, diabetes mellitus, hypertension were found to be important risk factors for VAT. Piperacillin+tazobactum and ceftriaxone+ sulbactam were the antibiotics with high susceptibility rates to common VAT pathogens. High resistance was seen with cefotaxime, ceftriaxone and gentamicin. Pseudomonas aeruginosa was the predominant ESβL (36%) and MβL (44%) producer. Klebsiella pneumoniae (40%) was predominant AmpC producer.62.5 % of Staphylococcus aureus were resistant to methicillin. VAT is common in mechanically ventilated intensive care unit patients. VAT is associated with longer durations of intensive care unit stay and mechanical ventilation. VAT is frequently caused by MDR organisms. Prophylactic or indiscriminate use of antibiotics should be discouraged for VAT.


Keywords: Ventilator associated tracheobronchitis, Mechanical ventilation, Endotracheal aspirates
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How to cite this article:

Mayuri, K.S. 2017. Ventilator Associated Tracheobronchitis: Incidence, Etiology, Predisposing Risk Factors and Drug Resistance.Int.J.Curr.Microbiol.App.Sci. 6(7): 3864-3879. doi: https://doi.org/10.20546/ijcmas.2017.607.398