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Research Article

JCR. 2020; 7(9): 481-485


RISK FACTORS AND ACINETOBACTER SPECIES GENOTYPES OF VENTILATOR ASSOCIATED PNEUMONIA: AN ORIGINAL ARTICLE

Harsha V. Patil, Shivaji T Mohite, Virendra C. Patil.

Abstract
Background:Ventilator-associated pneumonia (VAP) associated with Acinetobacterbaumanniicauses considerable morbidity in critical care. Aim and Objectives: To estimate the various risk- factors for the ventilator associated pneumonia (VAP) associated withAcinetobacter Species.Material and methods: This was a prospective,non-interventional study, conducted over a period of 2 years. Setting:This study was conducted, in the intensive care unit of a tertiary care teaching hospital. Ventilator associated pneumonia is the pneumonia developed forty-eight hours after endotracheal intubation and mechanical ventilation (MV). All the patients comprised in the study were supervised for the development of VAP by clinical and microbiological criteria. Statistical analysis: Data entry and analysis were made by SPSS for windows version SPSS 21.0 software (Chicago, Illinois, USA). Result: Total 246 patients had Acinetobacter isolates in patients with ventilator associated pneumonia VAP. The age between 50-59 and 60 and above were 26.62% in males and in female population age 50-59 years and 60 and above were 24.67% and 42.85% receptively. The age group 40-59 years and 60 and above were significantly frequent (‘p’< 0.01). Out of 246 Acinetobacter isolates, 188 (76.42%) were MDR Acinetobacter and 58 (23.57%) were non MDR Acinetobacter isolates. Out of 246 Acinetobacter isolates 22.76% isolates were from early onset VAP and 77.24 were late onset VAP. Amongst MDR Ab isolate (188) 11.17% were early onset VAP and 88.83% had late onset VAP. Non MDR Acinetobacter and MDR isolates were significantly high in late onset VAP (‘p’40 years, co-morbidities (COPD, IHD, HTN, DM, CKD), drugs (Prior antibiotic therapy, steroids H2 blockers, PP inhibitors), procedure (emergency intubation, duration of ventilator, CVC, Hemodialysis) Clinical and biochemical parameters [SOFA score (>5) and serum creatinine (>1.2)] and diagnosis (Cerebrovascular accidents) were linked with acinetobacter associated VAP.Coexistence of MBL and -OXA genes were meaningfully associated with various risk factors for development of VAP. Conclusion: Present study highlight the burden of modifiable risk factors in the form of co-morbidities, inappropriate antibiotic therapy, emergency intubation and prolonged ventilation were considerably associated with ventilator-associated pneumonia.

Key words: Ventilator-associated pneumonia, Acinetobacter Species, risk factors, MBL, OXA genes



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