VENTILATOR-ASSOCIATED PNEUMONIA

MICROBIOLOGY, MULTIDRUG RESISTANCE IMPACT AND ASSOCIATED RISK FACTORS IN TERTIARY HOSPITALS SETTINGS

Abstract

Background: Patients associated with VAP having mortality rates range from 20
to 50% and this may extend up to 70% when multi-resistant and invasive pathogens accountable
for infection, however, VAP is also interrelated with noteworthy rate of morbidity, extended
period of stay in ICU, protracted MV, and augmented hospitalization cost. Objectives: To review
the risk factors, incidence and transience rate of mortality for ventilator-associated pneumonia.
Design: Prospective and cross sectional way. Period: From April 2016 to December 2016.
Setting: Different Tertiary Care Institutes of Karachi, Pakistan. Method: A structured data
collection form was prepared to record the information and validated using spearman correlation
coefficient and Cronbach’s α value. Value of α = 0.902 and p = 0.913 have revealed the suitable
degree of reliability and uniformity. Data was collected with respect to gender, age, antibiotic
utilization record, and main diagnosis outcomes. Microbiological basis of ventilator-associated
pneumonia was assessed using patient lab record for rate and seclusion of organism. Results:
In this study a detail of significant virulence factor articulated by these microorganisms has
been depicted. Statistically insignificant differences were observed among the groups with
respect to clinical and demographic characteristics like mean age, gender, infection severity
scores (SOFA, MODS, CPIS and APACHE II), immune status of patients and type of the cases
including surgical or clinical scenario. 39.3% patients developed early onset while 60.6% of
cohort was observed with late onset of VAP. Conclusion: The precise microbial source of VAP
are numerous and diverse. The realistic challenge at the present time is to portray the authentic
approximate of the clinical consequences associated with VAP. Henceforth such investigations
may be supportive in origination of the most favorable institutional antimicrobial strategy to
reduce the associated complications of this threat.