Incidence and In-hospital Outcome of Ventilator Associated Pneumonia in Intensive Care Units of a Tertiary Care Hospital in Kashmir

INTRODUCTION: Ventilator Associated Pneumonia (VAP) is defined as pneumonia occurring in a patient within 48 hours or more after intubation with an endotracheal tube or tracheostomy tube and which was not present before. It is characterized by the presence of a new or progressive infiltrate, signs of systemic infection (fever, altered white blood cell count), changes in sputum characteristics, and detection of a causative agent. OBJECTIVES: The objective of this study was to assess the incidence and in-hospital outcome of VAP in patients admitted in ICUs of a tertiary care hospital in Kashmir. METHODS: An 18-month long prospective observational study was conducted, after obtaining ethical clearance from institutional review board, on 1178 adult patients admitted in various ICUs of our hospital who were on ventilator for more than 48 hours. and developed VAP by applying the Clinical Pulmonary Infection Score (CPIS) and The Hospitals in Europe Link for Infection Control through Surveillance (HELICS) criteria. The patients were thoroughly investigated and samples from the endotracheal tube/sputum and broncho-alveolar lavage were tested for microscopy, staining and cultures. Clinical course of these patients was assessed and patients were followed and in-hospital outcome was observed. RESULTS: Out of a total of 1178 patients admitted in ICU during this period, 129 (10.95%) developed VAP. Hypertension was the commonest comorbidity observed in 26 (20.16%) patients, followed by hypertension with diabetes in 14 (10.85%) patients whereas 56(43.41%) patients had no underlying comorbidity. The incidence of VAP was directly correlated with the total number of ventilator days. Acinetobacter in 32(24.80%) patients followed by Pseudomonas aeruginosa in 21(16.27%) patients was isolated from tracheal aspirates. Out a total of 129 VAP patients, 49(37.98%) died and 80(62.02%) were shifted to ward. CONCLUSION: Our study marks the importance of early detection, preventive plans and precise therapeutic strategies to improve outcomes in patients with VAP. KEYWORDS: Incidence, Endotracheal Tube, cultures, Broncho-alveolar Lavage