Ventilator-Associated Pneumonia and Causative Microorganisms in Intensive Care Unit: A Two Year Retrospective Analysis
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Original Article
P: 80-85
December 2016

Ventilator-Associated Pneumonia and Causative Microorganisms in Intensive Care Unit: A Two Year Retrospective Analysis

J Turk Soc Intens Care 2016;14(3):80-85
1. Sakarya Üniversitesi Egitim Ve Arastirma Hastanesi, Anesteziyoloji Ve Reanimasyon Klinigi, Sakarya, Türkiye
2. Sakarya Üniversitesi Tip Fakültesi, Enfeksiyon Hastaliklari Ve Klinik Mikrobiyoloji Anabilim Dali, Sakarya, Türkiye
No information available.
No information available
Received Date: 01.09.2015
Accepted Date: 23.06.2016
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ABSTRACT

Objective:

Ventilator-associated pneumonia (VAP) is the most common nosocomial infection in the intensive care units (ICUs). It causes prolonged hospital stay and increases mortality. In this study, we aimed to investigate the rate of VAP, causative microorganisms, and their antibiotic susceptibilities in anaesthesiology and reanimation ICU (ARICU).

Material and Method:

This retrospective study included patients who were admitted to 12-bed ARICU between January 2013 and December 2014. The detection of VAP was done according to Centers for Disease Control and Prevention criteria. The rate of VAP, VAP ratio, and ventilator utilization ratio (VUR) were calculated according to guidelines of Turkish National Infection Surveillance Control Group. Endotracheal aspiration samples were collected and cultivated. The identification of the isolates was performed by using VITEK-2 automated system. Antibiotic susceptibilities were determined by the disc diffusion method according to the Clinical and Laboratory Standards Institute criteria.

Results:

VAP was determined in 16 of 359 patients who required invasive mechanic ventilation for longer than 48 hours and hospitalized in ARICU. VUR was 65%, VAP ratio was 4.5% and the rate of VAP was 3.3 per 1000 ventilator days. Seventeen microorganisms were isolated from endotracheal aspiration samples, including Acinetobacter baumannii (n=6), Pseudomonas aeruginosa (n=4), methicillin-resistant Staphylococcus aureus (n=4), Klebsiella pneumoniae, Enterobacter cloacae and Serratia marcescens. The most sensitive antibiotics for microorganisms are listed as follows; Acinetobacter baumannii: colistin, Pseudomonas aeruginosa: amikacin, carbapenems; Methicillin-resistant Staphylococcus aureus: linezolid, teicoplanin, vancomycin, trimethoprim sulfamethoxazole; Klebsiella and Enterobacteriaceae species: carbapenems, trimethoprim sulfamethoxazole, gentamicin.

Conclusion:

Intermittent analyses and antibiotic susceptibilities of VAP causative microorganisms are important factors for scheduling appropriate empirical antibiotic treatment and detection of correct infection control strategies in ARICU. As a consequently, if VAP was suspected, empirical antibiotic therapy should be planned against gram-negative microorganisms.

Keywords:
Ventilator-associated pneumonia, intensive care unit, microorganism, antibiotic susceptibility