• J Infect Dev Ctries · Apr 2010

    Ventilator-associated pneumonia in a tertiary care hospital in India: role of multi-drug resistant pathogens.

    • Noyal Mariya Joseph, Sujatha Sistla, Tarun Kumar Dutta, Ashok Shankar Badhe, Desdemona Rasitha, and Subhash Chandra Parija.
    • Mahatma Gandhi Medical College and Research Institute, Pondicherry, India. noyaljoseph@yahoo.com
    • J Infect Dev Ctries. 2010 Apr 1; 4 (4): 218-25.

    BackgroundVentilator-Associated Pneumonia (VAP) is the most frequent intensive-care-unit (ICU)-acquired infection. The aetiology of VAP varies with different patient populations and types of ICUs.MethodologyA prospective study was performed over a period of 15 months in a tertiary care hospital to determine the various aetiological agents causing VAP and the prevalence of multidrug resistant (MDR) pathogens. Combination disk method, Modified Hodge test, EDTA disk synergy (EDS) test and AmpC disk test were performed for the detection of extended spectrum beta-lactamases (ESBL), carbapenemases, metallo-beta-lactamases (MBL) and AmpC beta-lactamases respectively.ResultsEnterobacteriaceae, Haemophilus influenzae, Staphylococcus aureus, Streptococcus pneumoniae, Candida spp. were more common in early-onset VAP, while non-fermenters (Pseudomonas spp. and Acinetobacter spp.) were significantly associated with late-onset VAP (P value 0.0267, Chi-square value 4.91). Thirty-seven (78.7%) of the 47 VAP pathogens were multidrug resistant. ESBL was produced by 50% and 67% of Escherichia coli and Klebsiella pneumoniae respectively. MBL was produced by 20% of P. aeruginosa. AmpC beta-lactamases were produced by 33.3% and 60.7% of the Enterobacteriaceae and non-fermenters respectively. Of the S. aureus isolates, 43% were methicillin resistant. Prior antibiotic therapy and hospitalization of five days or more were independent risk factors for VAP by MDR pathogens.ConclusionsVAP is increasingly associated with MDR pathogens. Production of ESBL, AmpC beta-lactamases and metallo beta-lactamases were responsible for the multi-drug resistance of these pathogens. Increasing prevalence of MDR pathogens in patients with late-onset VAP indicate that appropriate broad-spectrum antibiotics should be used to treat them.

      Pubmed     Free full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…