ABSTRACT
Ventilator associated pneumonia is the most prevalent and leading cause of death in Intensive care units (ICU). Directing therapy towards the most common organisms to Ventilator associated pneumonia (VAP) will improve case-rates survival and reduce emergence of resistant organism. Observational study was done to assess the causative Micro-organisms responsible for VAP and sensitivity of Micro-organisms to antibiotics in our ICU. 100 patients requiring mechanical ventilation > 48hrs in our ICU having clinical-pulmonary infection score (CPIS) >6 were prospectively studied over 8 months. After 48 hrs Tracheobronchial aspirate was done and repeated on 3rd and 7th day. All positive cultures were tested for drug sensitivity by Disc Diffusion method. Out of 100 patients 62 patients having CPIS >6, 40 were diagnosed of Microbiological origin. Organisms found were Staphylcoccus aureus (26%), Pseudomonas aeruginosa (24%), Klebsiella (8%), Streptococcus pneumonia (6%), E.,Coli (4%), Multi-drug Resistant Staphylcoccus Aureus (MRSA) (4%), Candida (20%). Monomicrobial was 28% and polymicrobial infection in 34% cases. Mortality in inappropriately treated patient was 88% compared to 42% in appropriately treated patient. Appropriate adequate initial treatment based on information provided by examination of pulmonary aspirates and drug sensitivity organisms would be helpful by decreasing mortality, morbidity and better out come in our ICU.
Key words: VAP, Staphylcoccus aureus, pseudomonas aeruginosa, Nosocomial infections, Tracheobronchial aspirate, ICU.