Emerging trends of nosocomial pneumonia in intensive care unit of a tertiary care public teaching hospital in Western India.

Background: Nosocomial pneumonia poses great challenge to an intensivist. Detailed information about hospital-acquired pneumonia (HAP) and ventilator-acquired pneumonia (VAP) is crucial for prevention and optimal management, thus improving quality Intensive Care Unit (ICU) care. Hence, we aimed to study the current trend of nosocomial pneumonia in ICU. Materials and Methods: It was a prospective observational cohort study, conducted in the ICU of a tertiary care teaching public hospital over a period of 18 months. We studied clinical profile and outcome of 120 adult patients who developed VAP/HAP during the study period. We also analyzed the causative organisms, antibiotic sensitivity, and resistance pattern in these patients. Results: Out of 120 patients, 29 patients were HAP and 91 patients were VAP. Mortality was 60% (72), and development of VAP and requirement of mechanical ventilation showed significant association with mortality ( P Staphylococcus aureus (43.4%) and VAP was Klebsiella pneumoniae (49%). Maximum antibiotic sensitivity was found to piperacillin + tazobactam (58.8%), followed by imipenem (49.5%) and meropenem (41.8%), whereas maximum antibiotic resistance was found to cefepime (95.1%), followed by ceftazidime and amoxicillin (91.2%). Conclusion: Nosocomial pneumonia showed high incidence (17.44%) and mortality (60%). Common organisms identified were S. aureus and K. pneumoniae . Resistance was high for commonly used antibiotics and high antibiotic sensitivity for piperacillin + tazobactam and carbapenem. Contexte: La pneumonie nosocomiale pose un grand defi a un intensiviste. Des informations detaillees sur la pneumonie acquise dans les hopitaux (HAP) et la pneumonie acquise par le ventilateur (VAP) sont essentielles pour la prevention et la gestion optimale, ameliorant ainsi les soins de soins intensifs de qualite (UTI). Par consequent, nous avons cherche a etudier la tendance actuelle de la pneumonie nosocomiale en UTI. Materiaux et methodes: il s'agissait d'une etude de cohorte observationnelle prospective menee dans l'UCI d'un hopital public d'enseignement tertiaire sur une periode de 18 mois. Nous avons etudie le profil clinique et le resultat de 120 patients adultes qui ont developpe le VAP / HAP pendant la periode d'etude. Nous avons egalement analyse les organismes responsables, la sensibilite aux antibiotiques et le modele de resistance chez ces patients. Resultats: Sur 120 patients, 29 patients etaient HAP et 91 patients etaient VAP. La mortalite etait de 60% (72), et le developpement du VAP et l'exigence de ventilation mecanique ont montre une association significative avec la mortalite ( P