Incidence of ventilator- associated pneumonia (VAP) and bacterial resistance pattern in adult patients hospitalised at the intensive care unit of Besat Hospital in Sanandaj

Among nosocomial infections, ventilator associated pneumonia (VAP) is very important which can lead to increased mortality rate in the patients. The aim of the present study was to determine the incidence of VAP and its bacterial resistance pattern at the intensive care unit (ICU) of Besat Hospital in Sanandaj.

In a prospective descriptive study carried out between September 2007 and June 2008, 149 endotracheal samples were obtained from the patients after 48 hours of hospitalization in ICU units of Besat Hospital. The samples were sent to the microbiology laboratory of Besat Hospital. Bacteriologic diagnosis was performed by using Edward & Ewings standard methods and antibiotic susceptibility pattern was determined by CLSI system guidelines. Demographic data were collected and recorded in a check list. Data were introduced into SPSS software and analyzed by means of descriptive statistical tests.

Among 149 samples from endotracheal tube of the patients, 48 were positive for VAP with an incidence rate of 32.2%. Mean standard deviation of duration of hospitalization was 23.4±10.2 days. Microorganisms isolated from endotracheal tube were essentially Enterobacteriacae and included Klebsiella spp, enterobacter spp, and E.coli. Acintobacter spp and Staphylococcus epidermidis, Pseudomonas spp and Staphylococcus aureus were detected from 3, 3, 2 and 1 samples respectively. The maximum and minimum antibiotic resistance by gram negative bacteria were 93.3% to cefalotin and 50% to amikacin.

The VAP incidence rate of 32.2% needs serious attention. Clinical isolates in the present study had a high antibiotic resistance especially to the third generation of cephalosporins. Close attention to the standards of infection control for prevention of VAP is recommended.