2019, Vol. 1, Issue 2, Part B

Material and Methods: This prospective observational study included 60 patients with a clinical and microbiological diagnosis of VAP and was carried out in the intensive care unit of a tertiary care institution. This study was conducted at the Department of Microbiology, Mamata Medical Collage, Khammam, Telangana, India from December 2018 to November 2019. The etiological agents were determined by collecting and cultureing bronchoalveolar lavage (BAL) and endotracheal aspirates. Followed CLSI protocols for antimicrobial susceptibility testing, which included the Kirby-Bauer disk diffusion method and MIC determination. Multiple drug-resistant (MDR), extensively drug-resistant (XDR), and pan-drug-resistant (PDR) isolates were studied for their prevalence.

Results: The study found that out of 60 patients, the most prevalent pathogens were Escherichia coli (10%), Acinetobacter baumannii (20%), Pseudomonas aeruginosa (25%), and Klebsiella pneumoniae (35%). Acinetobacter baumannii (85%) and Klebsiella pneumoniae (78%) exhibited resistance to carbapenems, cephalosporins, and aminoglycosides, indicating a significant incidence of multidrug-resistant organisms. For 70% of the multidrug-resistant strains, colistine and tigecycline still worked. A total of 40% of VAP patients died, with a considerably greater death rate (60%, p<0.05) in patients infected with multidrug-resistant bacteria.

Conclusion: This study shows that VAP cases have an alarmingly high risk of antibiotic resistance, which calls for new treatment approaches, stringent infection control measures, and antimicrobial stewardship programs. In order to decrease mortality and morbidity caused by VAP, it is crucial to identify resistant pathogens early on and utilize antibiotics wisely.