title: Incidence, bacteriology, and clinical outcome of ventilator-associated pneumonia at tertiary care hospital.
abstract: BACKGROUND
  Ventilator-associated pneumonia (VAP) is the most frequent Intensive Care Unit acquired infection.
  
  
  OBJECTIVE
  The aim is to determine the incidence, bacteriology and factors affecting VAP and to determine the multi-drug resistant (MDR) pathogens.
  
  
  METHODS
  This was a prospective observational study conducted over a period of 1 year from April 1, 2011, to March 31, 2012.
  
  
  METHODS
  The patients fulfilling criteria of VAP were included in this study.
  
  
  METHODS
  This was performed using SPSS trial version 11.0 software (SPSS Inc., Chicago, Illinois, USA) and the values ofP< 0.05 were considered statistically significant.
  
  
  RESULTS
  Totally 74 (27.71%) patients were developed VAP. Of total 74 patients with VAP 53 (71.62%) were females and 21 (28.37%) were females (P< 0.0001). Total 13 (17.56%) patients had early-onset VAP and 61 (82.43%) had late-onset VAP (P< 0.0001). The overall incidence of VAP rate per 1000 ventilator days was 39.59. Total 126 bacterial isolates found in 74 patients with VAP. Predominant isolates were Gram-negative 52 (70.27%). Total 41 (55.40%) patients had polymicrobial VAP, and 33 (44.59%) had single isolate. Total 55 (43.65%) isolates were MDR organisms. Total 22 patients with VAP succumbed during treatment with overall case fatality rate of 29.72%. Of total 55 MDR isolates in VAP, 13 (26.63%) wereKlebsiellaspp., 11(20%)Pseudomonas aeruginosa, 14 (25.45%)Acinetobacter, 8 (14.54%)Escherichia coli, and 9 (16.36%) coagulase positiveStaphylococcus aureus. Total 12 (21.41%) patients succumbed among MDR isolates.
  
  
  CONCLUSIONS
  There was a high incidence of MDR pathogens in late-onset VAP. The Gram-negative organismsKlebsiella,PseudomonasE. coliandAcinetobacterwere the most commonly isolated organisms with high mortality rates.
authors.affiliation: Department of Microbiology, Krishna Institute of Medical Sciences University, Satara, Maharashtra, India.
authors.forename: Harsha V
authors.initials: HV
authors.lastname: Patil
authors.affiliation: Department of Medicine, Krishna Institute of Medical Sciences University, Satara, Maharashtra, India.
authors.forename: Virendra C
authors.initials: VC
authors.lastname: Patil
keywords: Bacteriology; Intensive Care Unit; multi-drug resistant organisms; poly-microbial; ventilator-associated pneumonia