A STUDY OF CLINICAL AND MICROBIOLOGICAL PROFILE OF VENTILATOR-ASSOCIATED PNEUMONIA AND HOSPITAL-ACQUIRED PNEUMONIA IN PATIENTS ADMITTED AT TERTIARY CARE CENTER

VIJAYALAKSHMI KP; SRIKANTH AK; KEERTI KEERTI

doi:10.22159/ajpcr.2025v18i8.55020

Authors

VIJAYALAKSHMI KP Department of General Medicine, KLE Jagadguru Gangadhar Mahaswamigalu Moorsavirmath Medical College, Hubballi, Karnataka, India
SRIKANTH AK Department of General Medicine, Gulbarga Institute of Medical Sciences, Kalaburagi, Karnataka, India.
KEERTI KEERTI Department of Anaesthesiology, United Hospital, Kalaburagi, Karnataka, India. https://orcid.org/0009-0009-5666-220X

DOI:

https://doi.org/10.22159/ajpcr.2025v18i8.55020

Keywords:

Ventilator-Associated Pneumonia, Antimicrobial resistance, Mortality,, risk factors in ventilator‑associated pneumonia

Abstract

Objective: Ventilator-associated pneumonia (VAP) is a serious hospital-acquired infection that has a high death rate. The microbiological features of VAP have been the subject of only a few research conducted on small study populations in India. To evaluate the pathogen profile and identify the trend of antibiotic resistance, this study was conducted in the intensive care units (ICUs) of a tertiary care hospital.

Methods: A prospective investigation of clinically suspected VAP cases was conducted. Our analysis included 247 instances with clinical evidence of VAP who were admitted to ICUs on mechanical ventilation over 1 year. After undergoing a quantitative culture procedure on the endotracheal aspirate samples from these probable cases, a colony count of ≥105 colony-forming units/mL was deemed significant. A test for the isolates’ susceptibility to antibiotics was conducted.

Results: The incidence of VAP was more common in the elderly age group (45%) and predominated in males (57.5%) with a statistically insignificant p=0.3130. The majority of the patients were diagnosed with cerebrovascular accidents (41.25%). Poor outcome of VAP was associated with hypertension (51.25%) and diabetes mellitus (48.75%). Around 58 (72.5%) required intubation, and among the intubated, 29 (59.18%) showed improvement, and 29 (93.55%) patients died, with a significant p=0.0010. The majority of patients with VAP have demonstrated growth of Gram-negative organisms. Most of the Cefoperazone sensitive cases showed improvement (87.5%), with death in 12.5% cases, whereas the fatality rate was high in resistance cases (48.48%), which was statistically significant with a p=0.0140.

Conclusion: The mortality incidence was higher in antibiotic-resistant cases than the sensitive cases. The incidence of VAP may be reduced by carefully selecting patients who need ventilator support.

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References

1. Haliloglu M, Bilgili B, Bilginer H, Kasapoglu US, Sayan I, Aslan MS, et al. A new scoring system for early diagnosis of ventilator-associated pneumonia: LUPPIS. Arch Med Sci. 2020;16(5):1040-8. doi: 10.5114/ aoms.2020.97965, PMID 32863992

2. Liu C, Guo J. Characteristics of ventilator-associated pneumonia due to hypervirulent Klebsiella pneumoniae genotype in genetic background for the elderly in two tertiary hospitals in China. Antimicrob Resist Infect Control. 2018;7(1):95. doi: 10.1186/s13756-018-0371-8

3. Fernando SM, Tran A, Cheng W, Klompas M, Kyeremanteng K, Mehta S, et al. Diagnosis of ventilator-associated pneumonia in critically ill adult patients-a systematic review and meta-analysis. Intensive Care Med. 2020;46(6):1170-9. doi: 10.1007/s00134-020-06036-z

4. Golia S, Sangeetha KT, Vasudha CL. Microbial profile of early and late onset ventilator associated pneumonia in the intensive care unit of a tertiary care hospital in Bangalore, India. J Clin Diagn Res. 2013;7:2462-6.

5. Liu Y, Di Y, Fu S. Risk factors for ventilator-associated pneumonia among patients undergoing major oncological surgery for head and neck cancer. Front Med. 2017;11(2):239-46. doi: 10.1007/s11684-017- 0509-8, PMID 28493197

6. Set R, Bobade O, Shastri J. Bacteriology profile among patients with ventilator- associated pneumonia from a medical intensive care unit ATA tertiary care centre in Mumbai. Indian J Pathol Microbiol. 2011;54:432-3.

7. Chang L, Dong Y, Zhou P. Investigation on risk factors of ventilator-associated pneumonia in acute cerebral hemorrhage patients in intensive care unit. Can Respir J. 2017;2017:7272080. doi: 10.1155/2017/7272080, PMID 29391844

8. Charles MP, Easow JM, Joseph NM, Ravishankar M, Kumar S, Umadevi S. Incidence and risk factors of ventilator associated pneumonia in a tertiary care hospital. Australas Med J. 2013;6(4):178- 82. doi: 10.4066/AMJ.2013.1627, PMID 23671462

9. Mahavir J, Sneh L, Preeti K, Tulika M. Application of nanostructures in antimicrobial therapy. Int J Appl Pharm. 2018;10(4):11-25. doi: 10.22159/ijap.2018v10i4.25803

10. Karuniawati H, Yulianti T, Aini DK, Nurwienda FI. Impact of antimicrobial stewardship program on the use of antibiotics in pneumonia patients at teaching hospital in Surakarta Indonesia. Int J Appl Pharm. 2021;13(1):20-3. doi: 10.22159/ijap.2021.v13s1.Y0067

11. Khilnani GC, Jain N. Ventilator-associated pneumonia: Changing microbiology and implications. Indian J Crit Care Med. 2013;17(6):331-2. doi: 10.4103/0972-5229.123432, PMID 24501481

12. Joseph NM, Sistla S, Dutta TK, Badhe AS, Parija SC. Ventilator-associated pneumonia in a tertiary care hospital in India: Incidence and risk factors. J Infect Dev Ctries. 2009;3(10):771-7. doi: 10.3855/ jidc.396, PMID 20009278

13. Kumar U, Deepak R. Study of clinical and microbiological profile of ventilator-associated pneumonia in patients. Int J Pharm Clin Res. 2024;16(6):818-21.

14. Borisagar GB, Dedun AR, Solanki RN. Clinical, microbiological and mortality profile in ventilator-associated pneumonia in a tertiary care hospital in western India. Indian J Chest Dis Allied Sci. 2018;60:135-9.

15. Bhattacharjee S, Khyriem AB, Lyngdoh CJ, Prasad AK. A prospective study to determine the incidence, clinical profile, and outcomes of patients with ventilator-associated pneumonia. APIK J Int Med. 2022;20(20):1-6.

16. Chaudhury A, Rani AS, Kalawat U, Sumant S, Verma A, Venkataramana B. Antibiotic resistance & pathogen profile in ventilator-associated pneumonia in a tertiary care hospital in India. Indian J Med Res. 2016 Sep 1;144(3):440-6. doi: 10.4103/0971-5916.198679, PMID 28139543

17. Parthasarathy R, Sunny AA. A prospective observational study on antibiotic usage trends, risk factors and 28 days mortality rate associated with ventilator-associated pneumonia among medical ICU patients: Insights from a tertiary care hospital. Int J Pharm Pharm Sci. 2024;16(8):21-6. doi: 10.22159/ijpps.2024v16i8.51599

18. Kanipakam VK, Thoti H, Sharabu Y, Valluri AL, Gunti R. Bacteriological study of ventilator-associated pneumonia and antibiotic susceptibility of isolates. Int J Curr Pharm Res. 2024;16(2):112-6. doi: 10.22159/ijcpr.2024v16i2.4049