Early detection of ventilator-associated pneumonia using quantitative endotracheal aspirate cultures
Journal Title: Scholars Journal of Applied Medical Sciences - Year 2017, Vol 5, Issue 9
Abstract
Abstract: Ventilator associated pneumonia is commonly seen in patients in ICU, it results in increased costs of the treatment and increase in duration of hospitalization of patients. The objective of the present study was to determine the prevalence and antibiotic susceptibility profile of bacteria colonizing the endotracheal tubes in ICU. The study was carried out for a period of 5 years from Jan 2012 to Nov 2016. Data of 254 cultures were collected the sensitivity of cultures were recorded and analyzed. Endotracheal aspirates (ETA) and quantitative ETA tip cultures with a threshold of 10⁵ to 10⁶ bacteria per milliliter of exudates that is considered as optimal/ significant. Culture pairs were assessed for change in (1) species of bacteria isolated and (2) change in empiric antibiotic coverage. The results were analyzed using appropriate statistical methods. In 254 positive Cultures, the most frequently isolated organism was Acinetobacter baumannii (29.9%) followed by Klebsiella pneumonia (25.94%), Pseudomonas aeruginosa (18.11%), E.coli (8.25%). The total number of intubated cases complicated to Ventilator associated pneumonia( VAP ) were 54 cases ( 21.65% ) VAP associated mortalities – 10 cases ( 18 .18 %). Endotracheal aspiration is a simple, cost effective and it has proven to be highly effective as a diagnostic Technique. It is important to understand that Endotracheal tubes are susceptible to infections. Clinicians need to be aware of it and take prompt action if infection develops. Certain measures can reduce the risk of infections that includes early discontinuation of invasive devices, reduce intubation rates, recumbent patient positioning 30-45°, use of prophylactic probiotics. Keywords:Ventilator associated pneumonia, endotracheal aspirates, culture
Authors and Affiliations
Naveen Chandra Reddy, Lakshmi Jyothi T, Gresham Kulkarni
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