ANTIMICROBIAL RESISTANCE PATTERN OF BACTERIAL ISOLATES FROM VENTILATOR ASSOCIATED PNEUMONIA PATIENTS IN ICU ALONG WITH RISK STRATIFICATION

Background: Ventilator associated pneumonia (VAP) is one of the key challenges for critical care physicians. The study was done to identify the risk factors in patients developing VAP, the bacteriological profile and resistance pattern of the infective bacteria in our intensive care units (ICUs), and formulate empirical antibiotic policy.Methods: This prospective study was carried out over 1 year period in a Medical College in Kolkata. Out of 60 samples collected from patients admitted to ICU and requiring mechanical ventilation for more than 48 hours and suspected of having Ventilator associated events (VAE). Semi-quantitative culture of Deep tracheal aspirate (DTA) was processedResults: In the present study of 60 respiratory samples in the form of tracheal aspirate -50(83%) showed growth and 10 (17%) showed no growth. In the study, 98% of isolates were gram negative bacilli and Acinetobacter baumannii was the commonest isolate. Common co-morbidities include Cerebrovascular accident, puerperal sepsis, trauma, diabetic coma, and neurosurgery post-operative complications. Duration of ventilation and history of previous antibiotic use emerged as significant risk factors in the development of VAE in the ICU. Conclusion: VAP is associated with significant morbidity and mortality not only due to VAP but the underlying critical illness in the patients. Microbiological data should be used for formulating antibiotic policy of the institution. The pitfall in using empiric antibiotics for suspicion of VAP is the potential for antibiotic overuse, the emergence of resistance, and unnecessary adverse effects.