Surveillance of Ventillator Associared Pneumonia in A Tertiary Care Hospital.
Purpose: Surveillance of hospital-acquired infection (HAI), particularly device-associated infection (DAI), helps in determining the infection rates, risk factors, and in planning the preventive strategies to ensure a quality healthcare in any hospital. Ventilator-associated pneumonia (VAP) contributes to approximately half of all cases of hospital-acquired pneumonia.
Aim: The present study was carried out to know the incidence of VAP in a tertiary care teaching hospital of Punjab.
Materials and Methods: A prospective surveillance of ventilator associated pneumonia (VAP) was carried out between January 2014 and March 2017 in ICUs. Infection surveillance form for each patient on ventillator was filled. Endotracheal secretions from the suspected cases of VAP was collected using standard aseptic techniques and processed, as per standard guidelines. All the isolates were identified and antimicrobial sensitivity testing performed as per CLSI guidelines. An accurate record of total ventillator days for each of the indwelling devices under surveillance was maintained. The diagnosis of VAP was established using modified clinical pulmonary infection score (mCPIS), which was evaluated on a daily basis until the patient was on ventilator support.
Data, collected in the prescribed formats, were analysed on monthly basis; and then, compiled at the end of the every year. Descriptive analysis of the data was done and VAP rate was expressed as number of VAP per 1000 ventilator days.
Results: The overall VAP rate of VAP was found to be 5.32, 3.94,4.42 and 3.9 per 1000 ventilator days for the year 2014,2015,2016 and 2017 (Jan-March) respectively. Average number of ventilator days was significantly higher in patients who developed VAP as compared to those without VAP. The most common organisms isolated were Klebsiella pneumoniae and Acinetobacter baumannii.
Conclusions: Duration of indwelling devices was found to be the major risk-factor for acquiring VAP. Active surveillanceand strict adherence to preventive measures for VAP was extremely helpful i n reducing the VAP rate.