Bacteriological profile of ventilator-associated pneumonia in a tertiary care hospital
| Autor: | Ashoka Mahapatra, Somi Patro, Padma Das, Nirupama Chayani, Bimoch Projna Paty, D P Mohapatra, Gitanjali Sarangi |
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| Rok vydání: | 2018 |
| Předmět: |
Male
lcsh:QR1-502 Tigecycline medicine.disease_cause lcsh:Microbiology law.invention Tertiary Care Centers 0302 clinical medicine Risk Factors law Drug Resistance Multiple Bacterial 030212 general & internal medicine Ventilator-associated pneumonia Pneumonia Ventilator-Associated General Medicine Intensive care unit Anti-Bacterial Agents Trachea Intensive Care Units Staphylococcus aureus Pseudomonas aeruginosa Vancomycin Female lcsh:RB1-214 medicine.drug Microbiology (medical) medicine.medical_specialty India Microbial Sensitivity Tests Pathology and Forensic Medicine ventilator-associated pneumonia 03 medical and health sciences Enterobacteriaceae Internal medicine lcsh:Pathology medicine Humans Cefoxitin Bacteria business.industry bacterial infections and mycoses medicine.disease respiratory tract diseases Pneumonia Multidrug resistant Cross-Sectional Studies 030228 respiratory system business Polymyxin B |
| Zdroj: | Indian Journal of Pathology and Microbiology, Vol 61, Iss 3, Pp 375-379 (2018) |
| ISSN: | 0377-4929 |
| DOI: | 10.4103/ijpm.ijpm_487_16 |
| Popis: | Background: Ventilator-associated pneumonia (VAP) is the most frequent intensive care unit (ICU)-acquired infection. The etiology of VAP and their antimicrobial susceptibility pattern varies with different patient populations and types of ICUs. Materials and Methods: An observational cross-sectional study was performed over a period of 2 years in a tertiary care hospital to determine the various etiological agents causing VAP and to detect the presence of multidrug-resistant (MDR) pathogens in these VAP patients. Combination disk method, Modified Hodge test, ethylenediaminetetraacetic acid disk synergy test, and AmpC disk test were performed for the detection of extended-spectrum beta-lactamase (ESBL), carbapenemases, metallo-beta-lactamases (MBL), and AmpC beta-lactamases, respectively. Results: The prevalence of VAP was 35%. Enterobacteriaceae (66.66%) and Staphylococcus aureus (20%) were common in early-onset VAP, while nonfermenters (50%) and Enterobacteriaceae (40.61%) were predominant from late-onset VAP. Nearly 60.87% of the bacterial pathogens were MDR. ESBL was produced by 21.74% of Enterobacteriaceae. AmpC β-lactamase was positive in 35.29% nonfermenters and 26.08% Enterobacteriaceae. MBL was positive in 17.64% nonfermenters and 17.39% Enterobacteriaceae. Among the S. aureus isolates, 75% were cefoxitin resistant. Prior antibiotic therapy (P = 0.001) and hospitalization of 5 days or more (P = 0.001) were independent risk factors for VAP by MDR pathogens. polymyxin B, tigecycline, and vancomycin were the most sensitive drugs for Gram-negative and positive isolates respectively from VAP. Statistical Analysis: SPSS for Windows Version SPSS 17.0 (SPSS Inc., Chicago, IL, USA) and Chi-square with Yates correction. Conclusion: Late-onset VAP is increasingly associated with MDR pathogens. Treatment with polymyxin B, tigecycline, and vancomycin should be kept as last-line reserve drugs against most of the MDR pathogens. |
| Databáze: | OpenAIRE |
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