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Murine Oropharyngeal Aspiration Model of Ventilator-associated and Hospital-acquired Bacterial Pneumonia
04:32

Murine Oropharyngeal Aspiration Model of Ventilator-associated and Hospital-acquired Bacterial Pneumonia

Published on: June 28, 2018

Incidence of multidrug-resistant organisms causing ventilator-associated pneumonia in a tertiary care hospital: a

Arindam Dey1, Indira Bairy

  • 1Department of Microbiology, Kasturba Medical College, Manipal, India.

Annals of Thoracic Medicine
|September 4, 2009
PubMed
Abstract

Insights

Ventilator-associated pneumonia (VAP) affects 45.4% of patients on mechanical ventilation, with multidrug-resistant bacteria being common. Early diagnosis and targeted antibiotic strategies are crucial to combat this ICU infection.

Area of Science:

  • Critical Care Medicine
  • Infectious Diseases
  • Microbiology

Background:

  • Ventilator-associated pneumonia (VAP) is a significant intensive care unit (ICU) infection, occurring in 9-27% of mechanically ventilated patients.
  • Rising rates of multidrug-resistant organisms (MDROs) in ICUs present a critical challenge for timely and accurate VAP diagnosis and effective antibiotic treatment.

Purpose of the Study:

  • To determine the incidence of VAP caused by multidrug-resistant organisms.
  • To assess VAP in a multidisciplinary intensive care unit (MICU) within a large tertiary care hospital.

Main Methods:

  • A prospective study conducted from December 2005 to August 2006.
  • Enrolled patients requiring mechanical ventilation (MV) for over 48 hours.
  • Collected endotracheal aspirates (ETA) for quantitative cultures to diagnose VAP based on pathogen growth (≥10^5 cfu/ml).

Main Results:

  • The incidence of VAP was 45.4%, with 47.7% early-onset (<5 days MV) and 52.3% late-onset (>5 days MV).
  • Common pathogens included Acinetobacter spp. (47.9%) and Pseudomonas aeruginosa (27%).
  • High rates of resistance were observed, including extended-spectrum beta-lactamases (ESBLs) in Escherichia coli and Klebsiella pneumoniae, AmpC beta-lactamases in Acinetobacter spp., and metallo-beta-lactamases (MBLs) in Pseudomonas aeruginosa and Acinetobacter spp.

Conclusions:

  • The high incidence of VAP (45.4%) and the prevalence of multidrug-resistant organisms pose a significant threat in the MICU.
  • The findings suggest potential overuse or injudicious use of antimicrobial therapy.
  • Rotational antibiotic therapy and educational programs are recommended to combat MDROs and reduce VAP rates.
Keywords:
Multidrug-resistant organismsnosocomial pneumoniaventilator-associated pneumonia

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