Evaluation of Microorganisms Causing Ventilator-Associated Pneumonia in a Pediatric Intensive Care Unit

Abstract

Abstract Objective: The aim of this study was to identify microorganisms causing ventilator-associated pneumonia (VAP) and also study the antibiotic resistance/susceptibility. Materials and Methods: We retrospectively assessed microorganisms isolated from patients diagnosed with VAP in a pediatric intensive care unit between January 1, 2014, and June 30, 2016. Results: We included 44 patients diagnosed with VAP. The prevalence thereof was 8.6 patients per 1,000 ventilator days. Mechanical ventilation was required for 56.5% of patients. Thirty-three patients (75%) died. An underlying chronic disease was detected in 75% of patients (n=33). Fifty microorganisms were isolated from 44 patients. Single microorganisms were isolated from 86.4% (n=38) and two from 13.6% (n=6) of patients. Of all the isolated bacteria, 96% (n=48) were gram-negative; the most common was Pseudomonas aeruginosa (32%), followed by Klebsiella pneumoniae (24%) and Acinetobacter baumannii (22%). The isolates were most susceptible to colistin (92.6%), followed by piperacillin-tazobactam (71.4%), amikacin (65.2%), and gentamicin (52.2%). No enterobacterium or Acinetobacter strain was resistant to colistin; however, 13% of P. aeruginosa isolates were resistant. Conclusion: In VAP, it is essential to catalog antibiotic resistance patterns of bacteria present in the unit to ensure that empirical antibiotic therapy is effective.