Abstract

Background: Ventilator associated pneumonia (VAP) is a major cause of poor outcome among patients in the intensive care units (ICU) world-wide. We sought to determine the factors associated with development of VAP and its prognosis among patients admitted to different ICUs of a Tertiary Care Hospital in India. Methodology: We did a matched case control study during October 2009 to May 2011 among patients, ≥18 years with mechanical ventilation. Patients who developed pneumonia after 48 h of ventilation were selected in the case group and those who did not develop pneumonia constituted the control group. Patients′ history, clinical and laboratory findings were recorded and analyzed. Results: There were 52 patients included in each group. Among cases, early onset ventilator associated pneumonia (EVAP) occurred in 27 (51.9%) and late onset ventilator associated pneumonia (LVAP) in 25 (48.1%). Drug resistant organisms contributed to 76.9% of VAP. Bacteremia (P = 0.002), prior use of steroid/immunosuppressant (P = 0.004) and re-intubations (P = 0.021) were associated with the occurrence of VAP. The association of Acinetobacter (P = 0.025) and Pseudomonas (P = 0.047) for LVAP was found to be statistically significant. Duration of mechanical ventilation (P = 0.001), ICU stay (P = 0.049) and requirement for tracheostomy (P = 0.043) were significantly higher in VAP. Among each case and control groups, 19 (36.5%) expired. Conclusion: We found a higher proportion of LVAP compared with EVAP and a higher proportion of drug resistant organisms among LVAP, especially Pseudomonas and Acinetobacter. Drug resistant Pseudomonas was associated with higher mortality.

Original languageEnglish
Pages (from-to)337-342
Number of pages6
JournalIndian Journal of Critical Care Medicine
Volume17
Issue number6
DOIs
Publication statusPublished - 2013

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Ventilator-Associated Pneumonia
Tertiary Healthcare
Pseudomonas
Acinetobacter
Artificial Respiration
Intensive Care Units
Pneumonia
Pharmaceutical Preparations
Control Groups
Tracheostomy
Immunosuppressive Agents
Bacteremia
Intubation
Tertiary Care Centers
Ventilation
Case-Control Studies
India
Steroids

All Science Journal Classification (ASJC) codes

  • Critical Care and Intensive Care Medicine

Cite this

@article{59944a74d55a426784015beb890ec71d,
title = "Determinants of ventilator associated pneumonia and its impact on prognosis: A tertiary care experience",
abstract = "Background: Ventilator associated pneumonia (VAP) is a major cause of poor outcome among patients in the intensive care units (ICU) world-wide. We sought to determine the factors associated with development of VAP and its prognosis among patients admitted to different ICUs of a Tertiary Care Hospital in India. Methodology: We did a matched case control study during October 2009 to May 2011 among patients, ≥18 years with mechanical ventilation. Patients who developed pneumonia after 48 h of ventilation were selected in the case group and those who did not develop pneumonia constituted the control group. Patients′ history, clinical and laboratory findings were recorded and analyzed. Results: There were 52 patients included in each group. Among cases, early onset ventilator associated pneumonia (EVAP) occurred in 27 (51.9{\%}) and late onset ventilator associated pneumonia (LVAP) in 25 (48.1{\%}). Drug resistant organisms contributed to 76.9{\%} of VAP. Bacteremia (P = 0.002), prior use of steroid/immunosuppressant (P = 0.004) and re-intubations (P = 0.021) were associated with the occurrence of VAP. The association of Acinetobacter (P = 0.025) and Pseudomonas (P = 0.047) for LVAP was found to be statistically significant. Duration of mechanical ventilation (P = 0.001), ICU stay (P = 0.049) and requirement for tracheostomy (P = 0.043) were significantly higher in VAP. Among each case and control groups, 19 (36.5{\%}) expired. Conclusion: We found a higher proportion of LVAP compared with EVAP and a higher proportion of drug resistant organisms among LVAP, especially Pseudomonas and Acinetobacter. Drug resistant Pseudomonas was associated with higher mortality.",
author = "Kavitha Saravu and V. Preethi and Rishikesh Kumar and Vasudev Guddattu and Shastry, {Ananthakrishna Barkur} and Chiranjay Mukhopadhyay",
year = "2013",
doi = "10.4103/0972-5229.123435",
language = "English",
volume = "17",
pages = "337--342",
journal = "Indian Journal of Critical Care Medicine",
issn = "0972-5229",
publisher = "E-Flow Medknow Publications",
number = "6",

}

TY - JOUR

T1 - Determinants of ventilator associated pneumonia and its impact on prognosis

T2 - A tertiary care experience

AU - Saravu, Kavitha

AU - Preethi, V.

AU - Kumar, Rishikesh

AU - Guddattu, Vasudev

AU - Shastry, Ananthakrishna Barkur

AU - Mukhopadhyay, Chiranjay

PY - 2013

Y1 - 2013

N2 - Background: Ventilator associated pneumonia (VAP) is a major cause of poor outcome among patients in the intensive care units (ICU) world-wide. We sought to determine the factors associated with development of VAP and its prognosis among patients admitted to different ICUs of a Tertiary Care Hospital in India. Methodology: We did a matched case control study during October 2009 to May 2011 among patients, ≥18 years with mechanical ventilation. Patients who developed pneumonia after 48 h of ventilation were selected in the case group and those who did not develop pneumonia constituted the control group. Patients′ history, clinical and laboratory findings were recorded and analyzed. Results: There were 52 patients included in each group. Among cases, early onset ventilator associated pneumonia (EVAP) occurred in 27 (51.9%) and late onset ventilator associated pneumonia (LVAP) in 25 (48.1%). Drug resistant organisms contributed to 76.9% of VAP. Bacteremia (P = 0.002), prior use of steroid/immunosuppressant (P = 0.004) and re-intubations (P = 0.021) were associated with the occurrence of VAP. The association of Acinetobacter (P = 0.025) and Pseudomonas (P = 0.047) for LVAP was found to be statistically significant. Duration of mechanical ventilation (P = 0.001), ICU stay (P = 0.049) and requirement for tracheostomy (P = 0.043) were significantly higher in VAP. Among each case and control groups, 19 (36.5%) expired. Conclusion: We found a higher proportion of LVAP compared with EVAP and a higher proportion of drug resistant organisms among LVAP, especially Pseudomonas and Acinetobacter. Drug resistant Pseudomonas was associated with higher mortality.

AB - Background: Ventilator associated pneumonia (VAP) is a major cause of poor outcome among patients in the intensive care units (ICU) world-wide. We sought to determine the factors associated with development of VAP and its prognosis among patients admitted to different ICUs of a Tertiary Care Hospital in India. Methodology: We did a matched case control study during October 2009 to May 2011 among patients, ≥18 years with mechanical ventilation. Patients who developed pneumonia after 48 h of ventilation were selected in the case group and those who did not develop pneumonia constituted the control group. Patients′ history, clinical and laboratory findings were recorded and analyzed. Results: There were 52 patients included in each group. Among cases, early onset ventilator associated pneumonia (EVAP) occurred in 27 (51.9%) and late onset ventilator associated pneumonia (LVAP) in 25 (48.1%). Drug resistant organisms contributed to 76.9% of VAP. Bacteremia (P = 0.002), prior use of steroid/immunosuppressant (P = 0.004) and re-intubations (P = 0.021) were associated with the occurrence of VAP. The association of Acinetobacter (P = 0.025) and Pseudomonas (P = 0.047) for LVAP was found to be statistically significant. Duration of mechanical ventilation (P = 0.001), ICU stay (P = 0.049) and requirement for tracheostomy (P = 0.043) were significantly higher in VAP. Among each case and control groups, 19 (36.5%) expired. Conclusion: We found a higher proportion of LVAP compared with EVAP and a higher proportion of drug resistant organisms among LVAP, especially Pseudomonas and Acinetobacter. Drug resistant Pseudomonas was associated with higher mortality.

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U2 - 10.4103/0972-5229.123435

DO - 10.4103/0972-5229.123435

M3 - Article

VL - 17

SP - 337

EP - 342

JO - Indian Journal of Critical Care Medicine

JF - Indian Journal of Critical Care Medicine

SN - 0972-5229

IS - 6

ER -