National Academy of Agricultural Sciences (NAAS)
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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 |
Ventilator associated pneumonia (VAP) occurs in approximately 9-24% of patients who are mechanically ventilated. Emergence of multidrug resistance (MDR) among the pathogens causing VAP is contributing to the increase in morbidity and mortality. The objective of our study was to isolate aerobic bacterial pathogens causing VAP, determine their antibiogram and detect the presence of drug resistance in the pathogens. Endotracheal aspirates from 120 patients undergoing mechanical ventilation for >48h were collected and processed by semi-quantitative method. Isolates were identified by standard methods and antibiotic susceptibility was done using Kirby Bauer disc diffusion method. Combination disk method, Modified Hodge test, EDTA disk synergy test and AmpC disk test were performed for detection of extended spectrum beta-lactamases (ESBL), carbapenemases, metallo-beta-lactamases (MBL) and AmpC β-lactamases respectively. Out of 120 cases 33 patients were diagnosed to have VAP using modified Clinical Pulmonary Infection Score(CPIS).The organisms isolated were Acinetobacterspp (37.83%), Pseudomonas aeruginosa (24.32%) Klebsiella pneumoniae (13.52%), Escherichia coli (10.81%), Enterobacter spp (5.41%), Citrobacterkoseri (2.7%) and Staphylococcus aureus (5.41%). ESBL was produced by 50% of E.coli, 60% of K.pneumoniae, 100% of Enterobacter spp and C.koseri. MBL was produced by 44.44% of P.aeruginosa and 42.8 % of Acinetobacter spp. AmpC β-lactamases were produced by 71.43% of Acinetobacter spp, 44.44% of P.aeruginosa. VAP is associated with MDR pathogens. Rational antibiotic therapy for treatment of VAP will be beneficial to combat the increase in VAP caused by MDR pathogens.
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