Byline: Reena. Set, Omprakash. Bobade, Jayanthi. Shastri
Ventilator-associated pneumonia (VAP) is an important form of health care-associated pneumonia, specifically refers to pneumonia developing in a mechanically ventilated (MV) patient more than 48 h after tracheal intubation or tracheostomy. Due to increasing incidence of multidrug-resistant (MDR) organisms in intensive care units (ICU), early and correct diagnosis of VAP is an urgent challenge for optimal antibiotic treatment. The hypothesis behind the proposed study was to find whether such potential MDR organisms were a threat in our MICU. We also felt that the knowledge of local antimicrobial susceptibility patterns would surely guide the physician in the initial prophylactic treatment planning for patients on MV in our MICU.
The aim of the present study was to assess the incidence of VAP in the 15 bedded MICU of our tertiary care center. This prospective study was done from January to September 2005, enrolling patients undergoing MV for more than 48 h. Endotracheal aspirates (EA) were collected from the patients with suspected VAP, using a sterile mucus extractor and were sent to the microbiology laboratory immediately. A smear was prepared from the purulent portion of the sample and stained by Gram stain for semi-quantitative grading of polymorphonuclear neutrophils. [sup] Hundred microliters of the homogenized sample was added to 100 mL of sterile normal saline. Diluted samples were inoculated onto blood agar, MacConkeys agar, and chocolate agar by using a 4-mm nichrome wire loop, which holds 0.01 mL of sample. The plates were incubated overnight at 37[degrees]C. The...