ABSTRACT
Objective: To determine the frequency of different causative bacteriological organisms and their antibiotic sensitivity from Endotracheal Aspirate [EA] of patients suffering from Ventilator Associated Pneumonia [VAP]. Study Design: Prospective cross sectional study. Place and Duration of Study: Intensive Care Unit [ICU], Combined Military Hospital [CMH] Lahore, from May 2013 to Nov 2013
Material and Methods: A total of 180 cases of VAP, fulfilling the ?nclusion criteria and admitted in the ICU, were included in the study using the non-probability consective sampling technique. A written informed consent was obtained from the family. All these patients underwent endotracheal aspirate for microscopy and culture. Antibiotic sensitivity was determined using standard antibiotics regimens
Results: Out of 180 patients, 165 [91.7%] were culture positive while 15 [8.3%] were culture negative. Gramnegativebacilli accounted for about 70% of all isolates. The most common organism isolated was Pseudomonas aeruginosa 25% [n=45] followed by MRSA 18.9% [n=34], Klebsiella 15.6% [n=28], Actinobacter spp 13.3% [n=24], E.coli 11.7% [n=21] and Citrobacter spp 4.4% [n=8]. Carbapenem was the most sensitive drug that was seen in our setup but still 43.9% of the isolates showed resistance against it and resistance was noted still higher with Actinobacter spp, where 83% isolates were resistant. Quinolones showed resistance in 100% of the isolates of Actinobacter, MRSA and Citrobacter. While more than 50% strains of Pseudomonas, E.coli and Klebsiella were also resistant to quinolones. Cephalosporins showed excellent sensitivity towards gram negative bacteria which included Citrobacter [100% sensitive] and E.coli [80% sensitive]. Polymxins showed more than 50% sensitivity to Pseudomonas aeruginosa, Actinobacter, E. coli and Klebsiella
Conclusion: VAP remains a very important hospital-acquired infection. The most prevalent etiological organism in our study was Pseudomonas aeruginosa and the most effective antibiotics were carbapenems