title: Ventilator-associated pneumonia in a tertiary care intensive care unit: Analysis of incidence, risk factors and mortality.
abstract: BACKGROUND
  Ventilator-associated pneumonia (VAP) is the most common nosocomial infection diagnosed in the intensive care unit (ICU) and in spite of advances in diagnostic techniques and management it remains a common cause of hospital morbidity and mortality.
  
  
  OBJECTIVE
  The primary objective of the following study is to determine the incidence, various risk factors and attributable mortality associated with VAP and secondary objective is to identify the various bacterial pathogens causing VAP in the ICU.
  
  
  METHODS
  This prospective observational study was carried out over a period of 1 year. VAP was diagnosed using the clinical pulmonary infection score. Endotracheal aspirate (ETA) and bronchoalveolar lavage (BAL) samples of suspected cases of VAP were collected from ICU patients and processed as per standard protocols.
  
  
  METHODS
  Fisher's exact test was applied when to compare two or more set of variables were compared.
  
  
  RESULTS
  The incidence of VAP in our study was 57.14% and the incidence density of VAP was 31.7/1000 ventilator days. Trauma was the commonest underlying condition associated with VAP. The incidence of VAP increased as the duration of mechanical ventilation increased and there was a total agreement in bacteriology between semi-quantitative ETAs and BALs in our study. The overall mortality associated with VAP was observed to be 48.33%.
  
  
  CONCLUSIONS
  The incidence of VAP was 57.14%. Study showed that the incidence of VAP is directly proportional to the duration of mechanical ventilation. The most common pathogens causing VAP were Acinetobacter spp. and Pseudomonas aeruginosa and were associated with a high fatality rate.
authors.affiliation: Department of Microbiology, G. R. Medical College, Gwalior, Madhya Pradesh, India.
authors.forename: Neelima
authors.initials: N
authors.lastname: Ranjan
authors.affiliation: Department of Microbiology, PGIMS, Rohtak, Haryana, India.
authors.forename: Uma
authors.initials: U
authors.lastname: Chaudhary
authors.affiliation: Department of Pulmonary and Critical Care Medicine, PGIMS, Rohtak, Haryana, India.
authors.forename: Dhruva
authors.initials: D
authors.lastname: Chaudhry
authors.affiliation: Department of Microbiology, G. R. Medical College, Gwalior, Madhya Pradesh, India.
authors.forename: K P
authors.initials: KP
authors.lastname: Ranjan
keywords: Incidence; intensive care unit; mortality; risk factors; ventilator-associated pneumonia