Ventilator-associated pneumonia in Coronary Care Unit of a tertiary level hospital in Bangladesh: causative organisms and pattern of antibiotic sensitivity

Authors

  • Md Rezaul Karim Associate Professor, Department of Cardiology, Ibrahim Cardiac Hospital & Research Institute, Dhaka, Bangladesh.
  • Rita Mayedah Assistant Registrar, Department of Cardiology, Ibrahim Cardiac Hospital & Research Institute, Dhaka, Bangladesh
  • Fathima Aaysha Cader Registrar & Specialist, Department of Cardiology, Ibrahim Cardiac Hospital & Research Institute, Dhaka, Bangladesh

DOI:

https://doi.org/10.3329/bccj.v7i2.43454

Keywords:

Ventilator-Associated Pneumonia (VAP), Multi drug resistant (MDR), Coronary Care Unit (CCU), invasive mechanical ventilation (IMV)

Abstract

Background: Ventilator-Associated Pneumonia (VAP) is a frequent nosocomial infection. The etiology of VAP varieswith different patient populations and types of critical care settings.

Materials & methods: This prospective observational study was conducted at the Coronary Care Unit (CCU) ofIbrahim Cardiac Hospital & Research Institute from April 2016 to November 2016. Demographic details andincidence of VAP was recorded and analysed by appropriate statistical tests.

Results: 52 patients required mechanical ventilation, of whom 19 (36.5%) developed VAP. 15 (78.9%) had early VAP,while 4 (21.2%) had late VAP. CPIS, Modified CPIS and APACHE II Score- all were significantly higher among thosewho developed VAP (p<0.01). The most frequent indication for intubation among those who developed VAP was type Irespiratory failure (57.9%), type II respiratory failure (15.8%) and post-cardiac arrest (26.3%). Acinetobacter (31.6%)was the commonest organism isolated on tracheal aspirate, followed by Pseudomonas (21.05%), Candida (21.05%)and Klebsiella (10.5%). Acinetobacter, Klebsiella and MRSA were the organisms isolated from tracheal aspirates ofthose with late onset VAP. Acinetobacter was mostly sensitive to Colistin, 80% of Pseudomonas is also sensitive tosame. A number of organisms were resistant to Amikacin and Imipenem.

Conclusion: The commonest organism responsible for VAP in our CCU was Acinetobacter, which was largely sensitiveto Colistin. The emergence of antibiotic resistance of microorganisms causing VAP is a matter of serious concern inthis study. Regular surveillance of antibiotic susceptibility pattern is very important to prevent multi-resistant bacterialinfections.

Bangladesh Crit Care J September 2019; 7(2): 73-76

Downloads

Download data is not yet available.
Abstract
1
PDF
3

Downloads

Published

2019-10-08

How to Cite

Karim, M. R., Mayedah, R., & Cader, F. A. (2019). Ventilator-associated pneumonia in Coronary Care Unit of a tertiary level hospital in Bangladesh: causative organisms and pattern of antibiotic sensitivity. Bangladesh Critical Care Journal, 7(2), 73–76. https://doi.org/10.3329/bccj.v7i2.43454

Issue

Vol. 7 No. 2 (2019)

Section

Original Articles

License

Upon acceptance for publication the copyright of the paper automatically transfers to the BCCJ and will not be published elsewhere either in part or whole without written permission of the copyright holder.

Except for personal use, no part of the materials published in this journal may be reproduced, stored in a retrieval system or transmitted in any form or by any means electronic, photocopying, recording or otherwise without the prior written permission of the publisher.