DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20161420

Clinical profile of hospital acquired pneumonia in a tertiary care hospital, South India

Vasuki V.

Abstract


Background: Hospital acquired infections continue to be an important cause of morbidity and mortality among hospitalized patients. Hospital acquired pneumonia (HAP) results in a significant increase in the cost of care of hospitalized patients. Its development prolongs a patient’s stay in the Intensive Care Unit (ICU). Accurate information concerning the clinical profile of HAP is lacking in South India. This study was conducted prospectively to evaluate the clinical profile of HAP in ICU patients.

Methods: This prospective study was conducted over a period of one year among 2454 patients admitted in IMCU of Coimbatore Medical College & Hospital, Tamil Nadu. The specimens’ sputum, bronchoscopic alveolar lavage (BAL) and endotracheal aspirate (ETA) were collected for microbiological confirmation and processed using standard laboratory techniques.

Results: Out of 2454 cases, 253 (10.3%) patients developed HAP.  The incidence of HAP was higher (55.73%) in the age group more than 60 years. Out of 1352 patients on mechanical ventilation, 62.0% of patients (n=157) developed HAP.

Conclusions: This study provides an insight into the incidence of HAP with the occurrence being most in the age group more than 60 years. Our study also highlights that mechanical ventilation was an important risk factor for the development of HAP..


Keywords


Hospital acquired pneumonia, Intensive care unit, Mechanical ventilation

Full Text:

PDF

References


Hunter JD. Ventilator associated pneumonia. J Postgrad Med. 2006;82:172-8.

Mehta RM, Niederman MS. Nosocomial pneumonia in the intensive care unit: controversies and dilemmas. J Intensive Care Med. 2003;18(4):175-88.

Hoffken G, Niederman MS. Nosocomial pneumonia; the importance of a de-escalating strategy for antibiotic treatment of pneumonia in the ICU. Chest. 2002;122:2183-96.

File TM. Hospital-acquired (nosocomial) pneumonia in adults. Up To Date. 2006; Verson 15.1.

Read RC. Bacterial infections of the lower respiratory tract volume-1. 10th edition Topley & Wilson’s; 2005:640.

Davis KA. Ventilator-Associated pneumonia: a review. J Intensive Care Med. 2006;21:211-26.

Merchant M, Karnad DR, Kanbur AA. Incidence of nosocomial pneumonia in a Medical Intensive Care Unit and general medical ward patients in a public hospital in Bombay, India. J Hosp Infect. 1998;39(2):143-8.

Centers for disease control and prevention: guidelines for prevention of nosocomial pneumonia. MMWR Recomm Rep. 1997;46(RR-1):1-79.

Forbes BA, Sahm DF, Weissfeld AS. Bailey & Scott’s diagnostic microbiology. 12th edition. US: Mosby; 2007:807-12.

Collee JG, Fraser AG, Marmion BP, Simmons A. Mackie & McCartney practical medical microbiology. 14th edition. Netherlands: Elsevier; 2006:62-66.

Mukhopadhyay C, Anudida B, Ayyagari A. Role of mechanical ventilation & development of multi drug resistant organisms in hospital acquired pneumonia. Indian J Med Res. 2003;118:229-35.

Rakshit P, Nagar VS, Deshpande AK. Incidence, clinical outcome and risk stratification of ventilator-associated pneumonia: a prospective cohort study. Indian J Crit Care Med. 2005;9:211-6.

Vincent JL, Bihari DJ, Suter PM, Bruining HA, White J, Nicolas-Chanoin MH, et al. The Prevalence of nosocomial infection in Intensive Care Units in Europe: Results of the european prevalence of infection in intensive care (EPIC) study. EPIC Intern Advisory Comm. JAMA. 1995;274:639-44.

Dey A, Bairy I. Incidence of multi drug-resistant organisms causing ventilator-Associated pneumonia in a tertiary care hospital: a nine month’s prospective study. Ann Thorac Med. 2007;2:52-7.

Sopena N, Sabira M. Multicentre study of hospital acquired pneumonia in non-ICU Patients. Chest. 2005;127(1):213-9.

Berba R, Alejandria M, Rosacos J. Incidence, risk factors and outcome of hospital acquired pneumonia in critically ill patients at the Philippine general Hospital. Phil J Microbiol Infect Dis. 1999;28(2):29-38.

Chevret S, Hemmer M, Carlet J, Langer M. Incidence and risk factors of pneumonia acquired in Intensive Care Units. Results from a multicentre prospective study on 996 patients. European Cooperative Group on Nosocomial Pneumonia. Intensive Care Med. 1993;19(5):256-64.

Alp E, Guven M, Yildiz O, Aygen B, Voss A, Doganay M. Incidence, risk factors and mortality of nosocomial pneumonia in intensive care units: a prospective study. Ann Clin Microbiol Antimicrobials. 2004;3:17.

Trivedi TH, Shejale SB, Yeolekar ME. Nosocomial Pneumonia in medical intensive care unit. J Assoc Physicians India. 2000;48(11):1070-3.

Pawar M, Mehta Y, Trehan N, Kulkarni V. Ventilator-Associated Pneumonia: Incidence, risk factors, outcome, and microbiology. J Cardio thorac Vasc. 2003;17:22-8.

Celis R, Torres A, Gatell JM, Almela M, Rodríguez-Roisin R, Agustí-Vidal A. Nosocomial pneumonia: a multivariate analysis of risk and prognosis. Chest. 1988;93:318-24.

Muhammad FR, Yasmin H, Menon AR, et al. Pattern of Nosocomial Infection in two Intensive Care Unit of a tertiary care hospital in Karachi. JC PSP. 2007;17(3):136-9.