scholarly journals Microbial Profile of Early and Late Onset Ventilator Associated Pneumonia in The Intensive Care Unit of A Tertiary Care Hospital in Bangalore, India

2013 ◽  
Author(s):  
Sangeetha K. T
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Tertiary Care Hospital ◽  
Late Onset ◽  
Tertiary Care ◽  
Ventilator Associated Pneumonia ◽  
Care Hospital ◽  
Microbial Profile

#52: Role of Good Oral Hygiene in Reducing and Preventing Ventilator-associated Pneumonia (VAP) in the Intensive Care Unit (ICU) in a Tertiary Care Hospital

2021 ◽  
Vol 10 (Supplement_1) ◽  
pp. S20-S20
Author(s):  
Mansoor Asma ◽  
Sohani Komal
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Oral Hygiene ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Oral Care ◽  
Chlorhexidine Gluconate ◽  
Ventilator Associated Pneumonia ◽  
Care Hospital ◽  
Vap Bundle

Abstract Background Ventilator-associated pneumonia (VAP) is when a patient who received mechanical ventilation for at least 48 hours develops pneumonia. According to the literature, the prevalence rate of VAP in patients experiencing mechanical ventilation is 9%–68%, its resulting mortality is 30%–70%, it also extends hospital and ICU stay by 6–7 days, raises healthcare costs by $40,000 per patient. VAP is a serious complication in the critically ill one factor causing VAP is an aspiration of oral colonization which may result from poor oral hygiene care. Oral hygiene care using either a mouth rinse or with help of forceps and gauze or combination together with the aspiration of secretion can reduce the risk of VAP in these critically ill patients. Method The main aim of this study was to evaluate the effect of strengthening oral hygiene practices and develop cost-effective and easy to use protocols of oral hygiene for ventilator-dependent patients. This study is an observational study conducted in all intensive care unit at tertiary care hospital, 41 bedded inpatient critical care area including high dependency unit (HDU)/coronary care unit (CCU), medical intensive care unit (MICU), surgical intensive care unit (SICU), neonate intensive care unit (NICU) and pediatric intensive care unit (PICU). Approximately 500 patients were admitted monthly to the intensive care unit. All ventilated patients admitted to the intensive care unit are included. Intervention is done in three phases: firstly, VAP device-associated infection (DAI’s) surveillance initiated according to the CDC guideline. HAI’s surveillance was done on daily basis. Secondly, educate staff regarding DAI’s surveillance, VAP bundle, Oral care and suction technique of ventilated patient). Ongoing training and hands-on practice on mannequin and also perform sign-off on the patient first under supervision of Nurse instructor and infection control officers. Finally, VAP bundle was initiated which include elevation of head, daily sedation vacation, and assessment of readiness to extubate, daily oral hygiene care, and assessment of stress ulcer and deep venous thrombosis prophylaxis. Result Before implementation, we just calculate all pneumonia rates together not using proper guidelines. But after we follow CDC guideline for DAI’s surveillance, we trained more than 50% of critical care staff out of 93 staffs, and 90% to 95% compliance of using chlorhexidine gluconate for oral care at least per shift and also as per patient needed observed in ventilated patients. Conclusion The implementation of these changes in practices along with using chlorhexidine gluconate products has made it possible to achieve goal and staff perform work according to the best practice guideline. Oral care hygiene using chlorhexidine gluconate (CHG) as an element of the ventilator bundle is supposed to decontaminate the mouth, avoid aspiration of contaminated secretion into the respiratory tract and prevent VAP.

scholarly journals Microbial Profile and Antibiogram of Ventilator Associated Pneumonia at Tertiary Care Hospital U.P

2021 ◽  
Vol 10 (11) ◽  
pp. 10-18
Author(s):  
Anil Singh Yadav R. Sujatha ◽  
Dilshad Khan Dilshad Arif ◽  
Astha Gupta
Keyword(s):  
Tertiary Care Hospital ◽  
Late Onset ◽  
Tertiary Care ◽  
Hospital Setting ◽  
Research Centre ◽  
Ventilator Associated Pneumonia ◽  
Care Hospital ◽  
Healthcare Associated Infection ◽  
College Hospital ◽  
Microbial Profile

Ventilator associated pneumonia (VAP) is a common and serious healthcare associated infection (HAI). VAP is inflammation of lung parenchyma caused by infectious agents that develops in a patient who is on a ventilator occurring 48-72 hrs or more after tracheal intubation and mechanical ventilation (MV). The risk of VAP is highest early in the course of hospital stay, and is estimated to be 3%/day during the first 5 days of ventilation, 2%/day during days 5-10 of ventilation and 1%/day after this. Aim of this study was find out the Microbial profile and antibiogram of ventilator associated pneumonia at tertiary care hospital U.P. This study was conducted in the Department of Microbiology, Rama Medical College, Hospital & Research Centre, Kanpur India from January 2016 to December 2016. A total of 100 Endotracheal aspirated samples were collected in a sterile & labelled clean dry container from the clinically suspected cases of VAP patients. Out of 100 patients 31 patients shown growth of the bacteria & considered as Ventilator Associated Pneumonia patients. And 69 patients have not shown any kind of growth. Acinetobacter baumanni, Pseudomonas aeruginosa, Enterobacter & Klebsiella Pneumoniae were the most common pathogens from both early & late onset VAP. Proper monitoring and strict implementation of infection control practices is very essential to reduce VAP in hospital setting. Also the short term use of invasive devices and judicious use of antibiotics are important in preventing VAP caused by these MDR pathogens.

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