Development of Bacteremia in Ventilator Associated Pnuemonia Patients at a Tertiary Care Hospital, Gujarat- A Prospective Study

Ventilator Associated Pneumonia (VAP) is second most common cause of nosocomial infection. It also increases length of stay in hospital & cost for the patient. The ‘American Thoracic Society’ guidelines for Hospital Acquired Pneumonia recognize that when bronchoscopy is not performed blood cultures may be of value both to isolate an etiologic agent & define severity. Aim: The present study was carried out to measure the prevalence of bacteremia in pt. with VAP. Methodology: In this prospective study 100 patients aged 0-12 years, admitted in ICU & put on ventilator at S.S.G.Hospital, Vadodara from 1st Sep. 2010 to 31st September 2011 were enrolled. The Endotracheal secretion culture & Blood culture were performed after 48hrs of ventilation. The samples were processed as per standard microbiological methods. In case of ET secretion culture, >106 cfu/ml was considered significant for the presence of bacteremia. Result: Of total 100 patients, 85 were Endotracheal secretion culture positive. Blood culture was positive in 38 of these 85 patients. Out of these 38 patients 30 (79%) patients showed the same organism as was recovered from the Endotracheal secretion culture. VAP was developed in 85% of patients (85 of 100) & bacteremia was present in 44% of VAP patients but 30 out of 38 (79%) cases of bacteremia were of pulmonary origin. Conclusion: The presence of Bacteremia in the patients with Hospital Acquired Pneumonia is considered to have important role for defining the aetiology.