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

Published on: June 28, 2018

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Bacteriological profile of ventilator-associated pneumonia in a tertiary care hospital

Somi Patro1, Gitanjali Sarangi1, Padma Das2

  • 1Department of Microbiology, S.C.B. Medical College, Cuttack, Odisha, India.

Indian Journal of Pathology & Microbiology
|July 14, 2018
PubMed
Abstract

Insights

Ventilator-associated pneumonia (VAP) is common in ICUs, with late-onset cases increasingly linked to multidrug-resistant (MDR) pathogens. Polymyxin B, tigecycline, and vancomycin show sensitivity against these resistant VAP strains.

Area of Science:

  • Infectious Diseases
  • Critical Care Medicine
  • Microbiology

Background:

  • Ventilator-associated pneumonia (VAP) is a frequent intensive care unit (ICU)-acquired infection.
  • The causative agents and antimicrobial resistance patterns of VAP vary significantly across different patient populations and ICU settings.

Purpose of the Study:

  • To identify the etiological agents responsible for VAP.
  • To determine the prevalence of multidrug-resistant (MDR) pathogens in VAP patients.
  • To analyze antimicrobial susceptibility patterns for effective treatment strategies.

Main Methods:

  • An observational, cross-sectional study conducted over two years in a tertiary care hospital.
  • Utilized combination disk, Modified Hodge, EDTA disk synergy, and AmpC disk tests to detect specific resistance mechanisms (ESBL, carbapenemases, MBL, AmpC).
  • Statistical analysis performed using SPSS and Chi-square test with Yates correction.

Main Results:

  • VAP prevalence was 35%, with distinct microbial profiles in early-onset (Enterobacteriaceae, Staphylococcus aureus) versus late-onset VAP (nonfermenters, Enterobacteriaceae).
  • Nearly 61% of bacterial pathogens isolated were multidrug-resistant (MDR).
  • Specific resistance mechanisms like ESBL, AmpC, and MBL were detected in significant proportions of isolates. Prior antibiotic use and prolonged hospitalization (>5 days) were independent risk factors for MDR-VAP.

Conclusions:

  • Late-onset VAP is increasingly associated with multidrug-resistant (MDR) pathogens, posing a significant clinical challenge.
  • Polymyxin B, tigecycline, and vancomycin demonstrated high sensitivity against Gram-negative and Gram-positive VAP isolates, respectively.
  • These agents should be considered crucial last-line treatment options for MDR VAP.
Keywords:
Multidrug resistantrisk factorsventilator-associated pneumonia

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