title: Ventilators in ICU: A boon or burden.
abstract: OBJECTIVE
  Ventilator-associated pneumonia (VAP) is a major challenge in intensive care units (ICUs). This challenge is even more discernible in a neurological setting owing to the predispositions of patients. Data on VAP in the neurology and neurosurgery ICUs (NNICUs) are scanty in developing countries. This study was conducted to find out the occurrence of VAP, its risk factors, microbiological profile, and antibiotic resistance in patients admitted to the NNICU of a tertiary care institute in India.
  
  
  METHODS
  Endotracheal aspirate and blood samples were collected from 100 patients admitted to the NNICU. Complete blood count, microscopic examination, culture and sensitivity testing of aspirate were done. Chest x-ray was also performed to aid in the diagnosis of VAP.
  
  
  RESULTS
  Incidence rate of VAP was found to be 24%. Acinetobacter baumannii was the most common pathogen (24.3%) isolated from patients with VAP, and all of these isolates were sensitive to meropenem. Duration of mechanical ventilation (P < 0.0001) and associated comorbid illness (P = 0.005) were found to be significantly associated with VAP, and the duration of mechanical ventilation was found to be the only independent risk factor (P < 0.0001).
  
  
  CONCLUSIONS
  This study highlights the risks and microbiological perspective of ventilator use among neurology patients so that adequate preventive strategies can be adopted on time.
authors.affiliation: Department of Neurology, Janakpuri Super Speciality Hospital, Janakpuri, New Delhi, India.
authors.forename: Man Mohan
authors.initials: MM
authors.lastname: Mehndiratta
authors.affiliation: Department of Neurology, GB Pant Hospital, New Delhi, India.
authors.forename: Rajeev
authors.initials: R
authors.lastname: Nayak
authors.affiliation: Department of Microbiology, Janakpuri Super Speciality Hospital, Janakpuri, New Delhi, India.
authors.forename: Sana
authors.initials: S
authors.lastname: Ali
authors.affiliation: Department of Neurosurgery, GB Pant Hospital, New Delhi, India.
authors.forename: Ajay
authors.initials: A
authors.lastname: Sharma
authors.affiliation: Institute of Liver and Biliary Sciences, New Delhi, India.
authors.forename: Natasha Singh
authors.initials: NS
authors.lastname: Gulati
keywords: Healthcare-associated infections (HAI); neurosurgery; ventilator-associated pneumonia (VAP)