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Ventilator Associated Pneumonia in a Newly Developed Tertiary Care Center ICU in New Delhi, India FREE TO VIEW

Vikas Maurya, MD; Puneet Khanna, MD; Rajesh Pande, MD; Sharmila Sengupta, MD; Tulsi Chugh, MD
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BLK Super Speciality Hospital - Respiratory, Critical Care & Sleep Medicine, New Delhi, India

Chest. 2013;144(4_MeetingAbstracts):384A. doi:10.1378/chest.1704223
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SESSION TITLE: ICU Infections Posters

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 30, 2013 at 01:30 PM - 02:30 PM

PURPOSE: To determine the incidence and causative pathogens of ventilator associated pneumonia (VAP) and compliance to its prevention strategies in a tertiary care intensive care unit (ICU).

METHODS: VAP was defined as per the definitions of the US Centers for Disease Control and Prevention National Nosocomial Infections Surveillance System (CDC-NNIS) and prospective cohort surveillance for VAP was done. The data on microbial isolates, antimicrobial resistance along with compliance of measures to prevent VAP were also collected and analyzed.

RESULTS: The data was collected from January 2010 to March 2012. A total of 3201 patients were hospitalized in the ICU, for an aggregate of 12,873 patient days. Seventy five patients developed VAP infections. The ventilator days were 4921 and this amounts to overall VAP rate of 15.24 infections per 1000 ventilator days. The incidence of early onset VAP (E-VAP) and late onset VAP (L-VAP) was 25.2% & 74.8% respectively. The most common pathogens identified were Acinetobacter baumanii, Pseudomonas aeruginosa, and Klebseilla spp. Most of these were multidrug resistant. There was low compliance to hand hygiene, head of bed elevation, daily sedation interruption and oral care.

CONCLUSIONS: There was increase incidence of VAP amongst other nosocomial infection in the ICU. Most of these VAP were late in onset (L-VAP) and were caused by multidrug resistant pathogens. It was felt that there was a need to improve compliance to VAP prevention measures as part of the routine management of patients with mechanical ventilation.

CLINICAL IMPLICATIONS: VAP is associated with increased morbidity and mortality and is the commonest nosocomial infection in ICU. Regular surveillance of such infection is important as it result in decrease in infection rates and improved quality of health care.

DISCLOSURE: The following authors have nothing to disclose: Vikas Maurya, Puneet Khanna, Rajesh Pande, Sharmila Sengupta, Tulsi Chugh

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