Abstract:
Background:
Ventilator-associated pneumonia (VAP) is a serious nosocomial infection that
occurs in mechanically ventilated patients, increasing morbidity, mortality, and
healthcare costs. It is one of the most common ICU-acquired infections, with a
significant impact on patient outcomes. Understanding the risk factors and microbial
profile of VAP is crucial for improving prevention and treatment strategies.
Aim:
This study aimed to assess the prevalence, risk factors, microbiological
profile, and outcomes of VAP in critically ill patients requiring mechanical
ventilation.
Materials and Methods:
A prospective observational study was conducted on 175 mechanically
ventilated patients in the medical ICU, fulfilling the inclusion criteria. Clinical data,
risk factors, microbiological findings, and patient outcomes were analysed.
Endotracheal cultures were performed, and antimicrobial susceptibility patterns were
evaluated. Statistical analysis was conducted using SPSS version 20, with significance
set at p<0.05.
Results:
The mean age of patients was 48.71 years, with a male preponderance
(70.9%). The mean duration of mechanical ventilation was 11.1 days, and VAP was
present in 74.3% of cases, with 44% classified as late-onset and 30.3% as early-onset
VAP. The most common risk factors included emergency intubation (68.6%),
impaired consciousness (64.6%), and prolonged mechanical ventilation (>7 days)
(58.3%). The predominant pathogens were Acinetobacter baumannii and Klebsiella
pneumoniae (20% each), with multidrug-resistant strains posing a significant
challenge. High resistance was noted against cephalosporins, fluoroquinolones, and
carbapenems, while Tigecycline remained highly effective (97.4% sensitivity). No
significant difference in patient outcomes was observed between VAP and non-VAP
groups, but prolonged ventilation, emergency intubation, and tracheostomy were
significantly associated with VAP development (p<0.05).
Conclusion:
VAP remains a major ICU concern, with emergency intubation, prolonged
ventilation, and tracheostomy being key risk factors. The high prevalence of
multidrug-resistant organisms highlights the need for strict infection control measures
and antimicrobial stewardship programs to improve patient outcomes.
