NOSOCOMIAL PNEUMONIA IN MECHANICALLY VENTILATED PATIENTS

Nosocomial Pneumonia

Abstract

Ventilator associated pneumonia (VAP) is a disease caused by different microorganisms and is associated with high mortality. The objective of this study was to ascertain the causative organisms of VAP and the mortality associated with this disorder. It was a prospective comparative study of 100 patients who underwent ventilatory support at a tertiary care teaching hospital (Combined Military Hospital Rawalpindi) from 1st July, 2000 to 30th June 2001. Patients who developed clinical signs of pneumonia are investigated by bronchoalveolar lavage(BAL) and blood culture.  In patients who were diagnosed as a case of VAP, microorganisms were identified by BAL (79%) and blood culture (21%). Patients who developed VAP were followed as well as the controls that do not developed VAP. Mortality among both groups was recorded. Outcome of the study showed organisms including Pseudomonas aeruginosa (26%), Staphylococcus aureus (20%), Acinetobacter spp. (9%), Proteus spp. (6%), Haemophilus spp. (6%), Escherichia coli (6%), Klebsiella spp. (3%), Streptococcus pneumoniae (3%), Corynebacteria spp. (3%), and Polymicrobial flora (9%). The mortality among the patients of VAP was 50% compared to 30 % among the patients without VAP. But this difference is non-significant. In conclusion VAP is developed by diverse groups of microorganisms with Pseudomonas aeruginosa, Staphylococcus aureus and Acinetobacter spp amongst the commonest pathogens. VAP is associated with higher percentage of mortality.