Highly drug resistant microorganisms causing ventilator associated pneumonia at a tertiary care center
Highly drug resistant microorganisms causing ventilator associated pneumonia at a tertiary care center

Summary/Abstract: Introduction Ventilator associated pneumonia (VAP) is one of the most frequent intensive care unit (ICU) acquired infections. In recent years there has been an increase in antibiotic resistance among causal agents of VAP. This study was carried out to assess the profile of culture isolates and their antimicrobial sensitivity from the endotracheal aspirates (ETA) of patients with clinically suspected ventilator associated pneumonia. Methods In this observational study, ETA was collected from patients who were on mechanical ventilation for >48 hours in the ICU with clinically suspected VAP. Samples were mechanically liquefied, homogenized and serially diluted for quantitative culture. Identification and antibiotic sensitivity of the isolate was performed using Vitek2 (BioMérieux, Marcy-l'Étoile, France). Results We received a total of 196 tracheal aspirates during the study period, out of which 100 samples showed growth. The most common isolate was A. baumannii (38%) followed by K. pneumoniae (33%). Among the Enterobacteriaceae group of organisms isolated (n=41), 37 isolates (90%) were extended spectrum beta lactamase (ESBL) producing organisms and 35% were metallo-β-lactamases (MBL) producers. All Staphylococcus aureus (n=3) isolates were methicillin resistant (MRSA). Conclusions Multidrug resistant organisms are now commonly reported from patients with VAP in our ICUs. A majority of the organisms were sensitive only to tigecycline and colistin. Our data suggest the need for strengthened infection control efforts in the intensive care unit, and for reevaluating compliance with the antibiotic stewardship programme.

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