Incidence of ventilator associated events among intubated patients in neurosurgery ICU of a tertiary health centre in India

Ventilator associated events (VAE) by Centers for Disease Control and Prevention (CDC) was created to overcome the difficulty in surveillance of ventilator associated pneumonia (VAP). Pathogens causing VAP vary from hospitals to hospitals thus necessitating the need for local surveillance. The objective was to calculate the incidence of VAE in our hospital, to assess various organisms responsible for PVAP and to analyse their sensitivity to different antibiotics. The study retro-prospectively analysed 53 patients by consecutive sampling who were intubated from January 2018 to November 2018 in Neuro surgery ICU of our hospital. We used CDC’s guidelines to report VAE. Patient’s case files were traced using their MRD numbers and data regarding causative organism and their culture and sensitivity reports were obtained. Out of 53 intubated patients, we had eight VAE. All of them were reported as possible ventilator associated pneumonia (PVAP). Prolonged ventilator days (> 5 days) were associated with increased risk of VAE in our study. The incidence and VAE rate per 1000 ventilation days were 15.1 % and was 29.6 respectively. Six patients (75%) had monomicrobial aetiology in which two patients died. Remaining two patients (25%) had polymicrobial aetiology. Klebsiella pneumoniae was seen in majority (n=6) of the patients. Colistin had the highest sensitivity to the isolates while Ampicillin was resistant to all four organisms. All of the organisms isolated were MDR pathogen which was resistant to most of the regular anti-biotics. Therefore, it is important to frame local antibiotic policies and precautions to prevent VAE in the future. Keywords: VAE, E coli, Acinetobacter.